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      My Exceptional Care

PROVIDING PERSONALIZED PLANS FOR EACH PATIENT

Contact

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Become a New Patient!

My Exceptional Care provides in-office health care services as well as telemedicine consultations. If you would like to become a new patient, please click on the New Patient Packet button below. You will then be connected to our paperless forms that are quick and easy to navigate. Simply, complete the packet as thoroughly as possible and then click the SUBMIT button. Your new patient request will be sent to our front desk staff and you will be contacted within 24 hours to be scheduled for a visit.


You may also obtain our new patient packets in the office. You are welcome to complete them in the office lobby or take them with you to return at a later date. We accept completed new patient packets by mail at:   4972 Lincoln Ave Ste 101, Evansville, Indiana 47715; fax 812-402-4611 or thru email to [email protected] . All forms will need to be completed and returned prior to the scheduling of your first appointment. 

New Patient Packet

Telemedicine Consent Form

Weight Loss Diet Form

Allergy Test Consent Form

Allergy Test Questionnaire

Pain Assessment Form

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