Brookville Pediatrics
Pediatrics & Family Medicine
Hours of Operation
PATIENT FORMS
Flu Vaccine Information Sheet (Inactive)
Flu Vaccine Information Sheet (Live)
IHSAA PPE Form for Sports Physical-IN (PDF)
OHSA Form for Sports Physical-OH (PDF)
School Medication Form (PDF)
Involvement in Care Form (PDF)
Records Release Form (PDF)
Healthy Habits Survey (PDF)
Office Authorization for Treatment of Child (PDF)
Modified / Toddlers (M-CHAT-R/F) (PDF)
Need to speak to a nurse? We offer nurse advice Monday-Friday during office hours. Call our office and press option 4 to speak to our nurse.
After-Hours Availability: Please call our after-hours nurse advice line at (765) 328-4324 or if it is a true emergency, please call 911.
