Drs. Detrick & Detrick, Inc.

Appointments: 419.893.3316

Your Visit

In order for us to provide the best care for you, it is very important that you bring the following items to your visit:

  • A list of your current medications, names and dosage of each, including over-the-counter medications and your pharmacy information 
  • Insurance card and co-pay, co-insurance or deductible
  • New Patients:

    Download a Patient Registration Form, Patient Health History  Form and Consent for HIPAA  Form and complete each and return them to our office prior to your appointment or bring them with you at the time of your visit

Document Download Patient Forms

Get Adobe AcrobatTo view the forms listed below, you will need Adobe Reader. You may download Adobe Reader for free at www.adobe.com.  Please bring your completed forms with you to our office at the time of your visit or send them to us prior to your appointment.

Patient Registration Form
 Notice of Privacy Practice
Patient Health History Form  Consent for HIPAA

 

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