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  • About Us
    • Dr. William J. Fecht Jr.
    • Dr. Paul K. Frederick
    • COVID-19 Information
    • Office Staff
    • Hours & Locations
    • Hospital Affiliations
  • Patient Information
    • Forms & Instructions
    • Policies
    • FAQ
    • Health Resources
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    • Office Visit Request
  • Physician
    • Referrals
    • Contact Physician
  • Contact Us
  • Online Payments
  • Home
  • About Us
    • Dr. William J. Fecht Jr.
    • Dr. Paul K. Frederick
    • COVID-19 Information
    • Office Staff
    • Hours & Locations
    • Hospital Affiliations
  • Patient Information
    • Forms & Instructions
    • Policies
    • FAQ
    • Health Resources
    • Prescription Refill Request
    • Office Visit Request
  • Physician
    • Referrals
    • Contact Physician
  • Contact Us
  • Online Payments
  • Home
  • About Us
    • Dr. William J. Fecht Jr.
    • Dr. Paul K. Frederick
    • COVID-19 Information
    • Office Staff
    • Hours & Locations
    • Hospital Affiliations
  • Patient Information
    • Forms & Instructions
    • Policies
    • FAQ
    • Health Resources
    • Prescription Refill Request
    • Office Visit Request
  • Physician
    • Referrals
    • Contact Physician
  • Contact Us
  • Online Payments

Referrals

ReferralsDevMaster2019-03-13T16:14:12-04:00
  • Please fill out the following information to refer a patient to Indiana Gastroenterology.
  • Patient Information

  • Insurance Information

    Please complete the information below or fax a copy of patient’s insurance card (front & back) to 317-819-5126.
  • Appointment Information

    Referrals for ERCP, PEG placement or colonoscopy (age over 75) at the discretion of the gastroenterologist may require an office consultation prior to their elective procedure.
    We will make every effort to schedule ‘urgent’ referrals within a week. Next day or same week scheduling may require physician-to-physician discussion.
    Multiple selections accepted; make no selections if any physician or first available desired.
  • Referring Physician Practice Information

  • Complete this section once if your physician has not previously referred to our practice.
  • Additional Information

    If "Yes", please fax pertinent records and test results to 317-819-5126.
  • (Person submitting form)

Indianapolis (primary) office

9002 N Meridian St, Suite 200
Indianapolis, IN 46260
Phone: (317) 872-1161
Fax: (317) 819-5126

Noblesville (satellite) office

325 Westfield Road, Suite D
Noblesville, IN 46060
Phone: (317) 872-1161
Fax: 317-819-5126

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Your physicians and staff at Indiana Gastroenterology are closely following the COVID-19 outbreak as are your primary care providers and referring physicians. Click here to read our full COVID-19 response information.

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