Patient Forms


 

If you are on your way to our office for the first time, we are going to need some information from you. There will be medical history paperwork to fill out, as well as various forms to sign. Depending on the individual, this paperwork can take from fifteen to thirty minutes to complete. Please plan your arrival time accordingly.

When you called to make your appointment, our receptionist or scheduler may have offered to mail the medical history form to you (if there was time for it to get to you before the day of your appointment). Alternately, we now offer the forms online.

"The New Patient Medical History" must be submitted BEFORE your scheduled appointment. If you need help, please ask someone or arrive 30 minutes before your scheduled appointment to complete online at the office.

(You will need Adobe Reader to open/view/print this file. If it is not already on your computer, you can download it here) When you select the link, a new window containing the medical history form will open. Print the form, fill it out, and bring it with you to your appointment.

Location
Kanuru Interventional Spine and Pain Institute
3445 Ridge Road
Highland, IN 46322
Phone: 219-206-2264
Fax: 219-923-3501
Office Hours

Get in touch

219-206-2264