(812) 482-7441

St. Thomas Medical Center
600 West 13th St. | Suite 200 
Jasper, IN 47546

Download Your Patient Forms

Below are downloadable patient forms that will save you time by allowing you to download and fill them out at your leisure in advance of your visit.

Please complete the following:

1) Yearly Patient History and Information Form

2) Patient Authorization for Disclosure of Health Information 

3) Questionnaire - Please choose the form applicable to your visit.

Please complete the following if applicable to you:

Hours of Operation

Monday thru Thursday - 7:30 a.m. to 5:30 p.m.
Friday - 7:30 a.m. to 4:30 p.m.
Saturday & Sunday - Closed

Contact Us

Toll Free: (800) 499-7044
Phone: (812) 482-7441
Fax: (812) 482-7444

(812) 482-7441

St. Thomas Medical Center
600 West 13th St. | Suite 200 
Jasper, IN 47546