Community Health Network

Ranked among the nation's most integrated healthcare systems, Community Health Network is Central Indiana's leader in providing convenient access to exceptional healthcare services, where and when patients need them—in hospitals, health pavilions, workplaces, schools and homes.

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Downloadable forms

After you've scheduled your appointment online with MedCheck WebAhead, save even more time by filling out your forms before you arrive at the MedCheck clinic. Download, print and complete the forms you need below (Adobe Reader required).

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

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

Adobe PDFParental 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.

Proud sponsor

  • Indiana Fever
  • Indianapolis Indians
  • Indiana Pacers
  • Ed Carpenter Racing
  • Indy Eleven
  • Indy Fuel

Health and wellness shopping

  • Wellspring Medical at Home for medical supplies and equipment
  • FigLeaf Boutique
  • Jasmine gift shop
  • Wellspring Pharmacy

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