Health History Form:

Click here to download our Health History Form.

You will need a printer to print out the form after you have filled it out. Once you have filled out the form you can fax it to us or bring it to your appointment.

Our Fax number is: 574-312-6923


You will need to have Adobe Reader installed on your computer to use this form.

©Krabill Family Medicine
Site designed by: Reflections Photography & Design