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R. Michael Meneghini, MD

Indianapolis Hip & Knee Care

  • Our Team
    • R. Michael Meneghini, MD
  • Specialties
    • Partial Knee Replacement
    • Total Knee Replacement
    • Cemented vs. Cementless Knee Replacement
    • Joint Pain
    • Hip Replacement Surgery
    • Outpatient Hip and Knee Replacement Surgery
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Medical Forms

Provided on our website are various forms that require completion prior to your visit and/or surgery. Please download the appropriate form as directed by your physician and/or staff by clicking on the name of the form. If you cannot access the form, please click on the Adobe icon. This will allow you to download this software, providing access to the forms. Please bring the completed form(s) with you to your scheduled visit. This will help expedite the registration process. Thank you.

Download Forms

  • HIPAA Privacy Notice
  • New Patient Questionnaire
  • Request for Medical Information
  • Authorization to Release Health Information

If you cannot access the forms you can click on the icon below to download the software.

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Contact Us

Terre Haute Office at Union Health
1725 North 5th Street, Terre Haute, IN 47804

Fort Wayne Office
1721 Magnavox Way, Suite B, Fort Wayne, IN 46804

Phone 317-620-0232 
Fax 260-208-9561

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