Contact Us Today: (765) 807-2770

Request an Appointment Time

If you would like to schedule an appointment we offer two convenient ways to do so. Appointments can be made by calling the office (765) 807-2770 or online below.


Personal Information

Address Information

Insurance Information

Reason for Appointment

Office schedule:

Saturday, Sunday & Monday – Closed
Tuesday & Wednesday – 8:30 AM – 6:30 PM
Thursday – 8:00 AM – 3:30 PM
Friday – 8:00 AM – 5:00 PM

When possible, please arrive at least 20 minutes early for your appointment for registration, insurance paperwork and to complete a health survey.

Patient Information Form (English)
Download: Patient Information Form (PDF)

Patient Information Form (Spanish)
Download: LRVLC Cuestionario de Paciente (DOC)

Patient History Form
Download: Patient Health and History Form (PDF)

Patient Questionaire Form (English)
Download: Questionaire (PDF)

Patient Questionaire Form (Spanish)
Download: Questionaire (PDF)

When you come for your appointment, please remember to bring the following:

* Identification
* Insurance card and any co-pay information
* List of current medications and any surgeries during the last 12 months
* Form of payment

To cancel an appointment:

If you need to cancel your appointment, we are happy to oblige. Please call the office during business hours and provide at least one day’s notice so that your appointment time can be allocated to another patient who is seeking treatment.