Patient Forms

hbraces3You may access the following forms to assist us with your care. Please complete the following forms and click the Submit to Dr. Avila button at the bottom of the form.

Doctor Referral Form

Appointment Request

Thank you for your interest in our services. Please fill out the information on our appointment request page, and one of our team members will contact you to schedule an appointment time. We look forward to seeing you soon.

The Office of Dr. Harold C. Avila

  • Muncie Office - 3303 W. Bethel Ave., Muncie, IN 47304 Phone: 765-282-3200
  • Anderson Office - 706 Walnut St., Anderson, IN 46012 Phone: 765-282-3200
  • Hartford Office - 1200 North Walnut Street, Hartford City, IN 47348 Phone: 765-282-3200

2022 © All Rights Reserved | Privacy Policy | Website Design By: Intrado | Login