Bookmark This Page
our practice
our staff
our facility
services
Patient Forms

The following form can be downloaded to your computer and printed at home. In order for our doctors to provide a complete and comprehensive medical opinion it is important that they review all your medical information. Please be prepared to provide this information to our office along with your current medical insurance information. Below is a link to our Notice of Privacy Practices form.


Need Adobe Acrobat Reader?

If you do not have a copy of Acrobat Reader you can get one for free by clicking on the icon 'Get Acrobat® Reader'. This will take you to Adobe's website and enable you to download the Acrobat program to your computer.

Home    Our Practice    Our Staff    Our Facility    Patient Forms     Contact Us    Maps & Directions    Terms of Use    Site Map
Ultrasound   Gynecology    Obstetrics    Infertility
Dr. John M. Brown, Dr. Thomas F. Downey, Dr. Dawn K. George, Dr. Michelle R. Harrison, Dr. William P. Ruckman,
Dr. Catherine T. Sam, Dr. Susan M. Schnerre, and Dr. Daniel R. Sunkel, serving Lafayette and the surrounding area.

Woman's Clinic of Lafayette: 3920 St. Francis Way, Suite 100 | Lafayette, IN 47905 | Tel: 765-428-5888 or 1-800-733-6944

Copyright © 2007 Woman's Clinic of Lafayette and MedNet Technologies, Inc.  All Rights Reserved.
MedNet-Sites™ - Powered by MedNet Technologies, Inc.