EFFECTIVE NOW: Due to the current increase in respiratory illnesses, Community Health Network has returned to a masking mandate in the hospital and any other CHN buildings where medical care is delivered.  This includes both buildings where we have our offices.  
COVID Information and Updates
Get Medical Advice:  Helpful resources to help you know how to best care for your child.

Form Upload and/or Ask a Question


To expedite the return of your form, complete the sections about your child, then email the form to [email protected] OR use the UPLOAD FILE button below the Patient Information boxes below. 

To send multiple pages, use a scanner app on the APP Store or Google Play.  Scan your documents with your device, then upload the one file here.   We will complete the form[s] and return them via secure email.  If emailing the form, please include your cell phone number so we can call you if we have any questions.


  • Please use the form below if you have a non-urgent question or request.  Requests will be addressed within one business day [no weekends or holidays].
  • If you need at-home care advice, visit our searchable mobile app NP PEDS MD, featuring a tile menu for easy access to answers on behavior concerns, COVID-19, common child illnesses, medication dosing charts, and dozens of other topics.   

Patient Information
Contact Information
Give first and last names
Use the format 317-555-1212
Give first and last names
Use the format 317-555-1212
Use the format MM/DD/YYYY
Submit question or request