Community Health Network

Patient Information / Registration
Required for every MedCheck visit, your patient information and registration form includes personal, financial, insurance and consent information.

IHSAA Pre-Participation Physical Evaluation Form
Before participating in sports at school, your child must provide a completed and signed physical evaluation form from their physician or other medical care provider. These physical evaluations may be obtained at any MedCheck location.

Parental Consent for Treatment of a Minor Form
Although you probably have someone to care for your children when you're going away, it's a good idea to make sure their health care needs are taken care of as well. By completing this form and providing all the proper signatures, you are granting permission for Community Health Network and our medical staff to provide medical assistance to your child when that child is under someone else's care.