New Patient Application

If you are interested in becoming a patient, please choose one of our physicians listed below and complete the corresponding three-page application. Once your application is reviewed, you will be notified of our decision by e-mail, mail, or phone.Thank you for your interest in Family Care Associates! 

Please include a photo ID and copy of your insurance card(s) when submitting applications.

Note: Forms are in Adobe PDF format. Click here for a free download of Adobe Acrobat Reader.

Dr. Amanda Bierman is accepting newborns to 18 years. 
APPLICATION

Dr. Colleen Bingham is accepting newborns to children through the age of 20.
APPLICATION
 

Dr. Michael Brummer is no longer accepting applications.

Dr. Jeffrey Brummer is accepting newborns to seniors. 
APPLICATION.

Dr. Jeffrey Crowell is accepting newborns to seniors. 
APPLICATION
 

Dr. Thomas Heischmidt is accepting newborns to seniors.
APPLICATION

Melissa Semple, PsyD is accepting all patient's
APPLICATION

Rebecca Holkenbrink, LCPC is accepting all patient's
APPLICATION

Kari Thompson, LCPC is accepting all patient's
APPLICATION

Thomas Moll, LCSW is accepting all patient's
APPLICATION

Thank you!