Online Forms


New Patients

Ingram Health Care P.C. offers our patient form(s) online so they can be completed in the convenience of your own home or office.

  • If you do not already have AdobeReader® installed on your computer, Click Here to download.

Please contact us by phone to schedule appointments.

  



intake
New Patient Health History Form -Required

This lets us know the history and current state of your health. What questions, concerns, goals, regarding wellness can we help you with? Let us know!

The link directly below can automatically upload to our software.  Once the entire New Patient Intake is filled out, you must hit the submit button. 

*PLEASE DO NOT FILL OUT ONLINE FORM ON YOUR CELL PHONE DEVICE, IT WILL NOT SUBMIT FORM. PLEASE FILL OUT ON A COMPUTER OR ON iPAD/TABLET ONLY!

online forms

PLEASE CALL OUR OFFICE WITH YOUR INSURANCE INFORMATION, AT LEAST 48 HOURS BEFORE SCHEDULED APPOINTMENT.

 IF WE DO NOT RECEIVE INSURANCE COVERAGE INFORMATION BEFORE SCHEDULED APPOINTMENT, YOU WILL BE CONSIDERED A CASH PATIENT.


M.V.A accident forms: Please print out forms, fill out, and bring with you to your new patient appointment.

*We DO NOT accept third party insurance.  Please notify our insurance specialist, Jessica,  if you have any questions. 


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Location

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Office Hours

Please reference Dr.'s individual hours at top of website

Canton Office

Monday:

7:00 am-4:00 pm

Tuesday:

7:00 am-4:00 pm

Wednesday:

7:00 am-4:00 pm

Thursday:

7:00 am-4:00 pm

Friday:

Closed

Saturday:

Closed

Sunday:

Closed