1200 North 7th Street, Chariton, Iowa 50049
Phone: (641) 774-8103 | Toll-free: (800) 404-3111 | Email: firstname.lastname@example.org
LCHC Medical Clinic is your local home for your family’s healthcare needs.
Our providers and clinic staff are proud to offer a comprehensive range of services. In addition to being able to handle the vast majority of your family’s acute medical needs, LCHC Medical Clinic offers comprehensive preventative medical services, including adult and pediatric immunizations, adult health maintenance visits, prenatal and obstetrical care, osteopathic manipulations, and well-pediatric care.
We are equipped to provide basic laboratory services within the clinic, such as cholesterol and diabetic testing, obstetrical and general diagnostic ultrasound examinations. We are also able to perform a variety of outpatient surgical procedures including dermatologic surgery, minor gynecologic procedures, and vasectomies.
Located on the Lucas County Health Center campus, our patients and providers have immediate and convenient access to the hospital’s laboratory, radiology department, emergency department, and physical therapy services. Our location also provides easy access to the medical, surgical, and obstetric departments of Lucas County Health Center.
LCHC’s Medical Clinic offers a highly skilled team of providers in order to offer you the best healthcare for you and your family’s needs.
LCHC Medical Clinic participates in many different insurance plans. Keep in mind, however, that any insurance company may have numerous, different plans in its offerings and we may not participate in all plans.
Please contact your insurance company directly or your employer’s Human Resource Department, who can provide you with the most current provider and benefit information specific to your insurance.
Choosing Wisely Campaign
Patients sometimes ask for tests and treatments that are not necessarily in their best interest and physicians often struggle with decisions about prescribing tests and procedures as a way of covering all basis. So the ABIM Foundation has joined with leading medical specialty societies to develop evidence-based lists of tests and procedures for patients and physicians to question as part of Choosing Wisely.
Although your medical record is the property of LCHC Medical Clinic, you have the right, at any time, to request a copy of any or all of your medical records. You also have the right, at any time, to request any or all of your medical records to be sent to another provider, clinic, hospital, or other facility. LCHC Medical Clinic’s medical records department is available from 8 AM – 5 PM, Monday through Friday, to assist you with obtaining copies of all or a portion of your health record, transferring your medical records, or answering any questions you may have about the process. Click the links below to download forms related to obtaining or transferring your medical record.
Before your initial visit to LCHC Medical Clinic, we ask that you complete a patient demographic form, which includes your insurance information, employment information, etc. We also ask that you complete a comprehensive health history questionnaire. This information helps our staff accurately enter your information into our computer database, as well as saving time during your initial nurse/physician interview.
For your convenience, these forms are available for you to download, print, and complete at home prior to your first appointment. Periodically, we will ask you to update this information. If there have been any changes to your insurance information or medical history, such as medication changes, be sure to mention that to the receptionist, nurse, or provider at the time of your visit. You may also download and complete the Patient Information Update Form below. We recommend you complete the Update Form yearly.
Well Child Visits
Parents who are bringing their child in for a Well Child Visit are encouraged to download the forms below and fill them out prior to their arrival.
M-CHAT (Modified Checklist for Autism in Toddlers): M-Chat Form (15 to 18 months)
ASQ-3 (Ages and Stages) Questionnaires:
- What is ASQ-3? Information Sheet
- 2 Month Questionnaire (1 month 0 days to 2 months 30 days)
- 4 Month Questionnaire (3 months 0 days to 4 months 30 days)
- 6 Month Questionnaire (5 months 0 days to 6 months 30 days)
- 8 Month Questionnaire (7 months 0 days through 8 months 30 days)
- 9 Month Questionnaire (9 months 0 days through 9 months 30 days)
- 10 Month Questionnaire (9 months 0 days through 10 months 30 days)
- 12 Month Questionnaire (11 months 0 days through 12 months 30 days)
- 14 Month Questionnaire (13 months 0 days through 14 months 30 days)
- 16 Month Questionnaire (15 months 0 days through 16 months 30 days)
- 18 Month Questionnaire (17 months 0 days through 18 months 30 days)
- 20 Month Questionnaire (19 months 0 days through 20 months 30 days)
- 22 Month Questionnaire (21 months 0 days through 22 months 30 days)
- 24 Month Questionnaire (23 months 0 days through 25 months 15 days)
- 27 Month Questionnaire (25 months 16 days through 28 months 15 days)
- 30 Month Questionnaire (28 months 16 days through 31 months 15 days)
- 33 Month Questionnaire (31 months 16 days through 34 months 15 days)
- 36 Month Questionnaire (34 months 16 days through 38 months 30 days)
- 42 Month Questionnaire (39 months 0 days through 44 months 30 days)
- 48 Month Questionnaire (45 months 0 days through 50 months 30 days)
- 54 Month Questionnaire (51 months 0 days through 56 months 30 days)
- 60 Month Questionnaire (57 months 0 days through 66 months 0 days)
ASQ:SE-2 (Ages and Stages: Social and Emotional) Questionnaires:
- What is ASQSE-2? Information Sheet
- 2 Month Questionnaire (1 month 0 days through 2 months 30 days)
- 6 Month Questionnaire (3 months 0 days through 8 months 30 days)
- 12 Month Questionnaire (9 months 0 days through 14 months 30 days)
- 18 Month Questionnaire (15 months 0 days through 20 months 30 days)
- 24 Month Questionnaire (21 months 0 days through 26 months 30 days)
- 30 Month Questionnaire (27 months 0 days through 32 months 30 days)
- 36 Month Questionnaire (33 months 0 days through 41 months 30 days)
- 48 Month Questionnaire (42 months 0 days through 53 months 30 days)
- 60 Month Questionnaire (54 months 0 days through 72 months 0 days)