MEMORIAL WEEKEND HOURS | 9/5: OPEN Sat 8:30–10 am @ Clearvista Office | 9/6: OPEN Sun 4:30–6 pm @ 146th St Office | 9/7: CLOSED MONDAY

Forms

PLEASE NOTE:  Health forms require reporting of current health information, so your child or adolescent must have had a well checkup within the last 12 months.

 

Miscellaneous Forms

NORTHPOINT FORMS

Various forms you may need for your child's healthcare are found under this section from treatment authorization to release of records forms.

Fax:       317.621.9190
Email:    NPfrontoffice@ecommunity.com

Athletic Forms

ATHLETIC | CAMP | DAYCARE FORMS

For your convenience, we offer common local athletic, camp and daycare forms below. Please download, print, and bring with you for your child's examination.  There is a $5 service fee to complete athletic, camp and daycare forms. 

 
 

What can we do better?

Parent feedback helps us do our work better. Let us know about your child's experience and feedback. Email Linda Kortanek at lkortanek@ecommunity.com.