Medical Patient Forms

In-Office Testing  |  Emergency Service Available  |  Over 35 Years of Experience

In-Office Testing

Emergency Service Available

Over 35 Years of Experience

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Hours:

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Download Your Patient Forms

Please download the forms to prepare for your appointment with Dr. Mohammad Alam, M.D., F.A.C.E., Providence Medical Group.

Information Release or Obtain Authorization Information Release Form Medication List Other Physician List Patient Registration Form Patient Privacy Release Form System Review Form

Member of the American Association of Clinical Endocrinologist

Call us to schedule an appointment.

(812) 238-7781

(812) 238-7781
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"Dr. Alam had helped save my life and his staff are THE BEST!! I cannot believe all the negative reviews complaining about wait time. He is working hard to ensure no stone is left unturned with every patient. Thank goodness he takes time to investigate because that's how it should be. His receptionist even sent materials to my home about my disease to help me understand everything and make me feel more comfortable."

- Stephanie Ridge

Learn More About

Dr. Mohammad Alam, M.D., F.A.C.E

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