our practice
- Michelle L. Endicott, D.O.
- Anthony B. Knell, P.A.-C
- Bradley Barnette, Office Manager
- Todd V. Kreitzer, D.O.
contact information
- Michelle Endicott, D.O.
- 4815 Kanawha Ave., SW
- South Charleston, West Virginia 25309
- Tel: 304-768-4567
- Fax: 304-768-2277
- Map
From Your Doctor service powered by Vivacare
This service should not be used in place of a visit, call, consultation with or the advice of your healthcare provider.
Communicate promptly with your provider with any health related questions or concerns.
Patient Forms
- Please print out the first three forms, fill them out and bring them to your appointment.
- The Notice of Privacy Practices is for your files. You can download it to your computer or print it out (Please Note: This document is 8 pages long if you choose to print it.)
- The Medical History Form must be updated yearly. If you have a follow-up appointment and your form is outdated, pleast print one out, fill it out completely and bring it to your appointment.
- It is also the patient's responsibility to notify the office of any changes in address, phone number, insurance info., etc.
Thank you and we look foward to seeing you.
Patient Registration Form (PDF)
Medical History Form (PDF)
HIPAA Consent Form (PDF)
Notice of Privacy Practices (PDF, 8 pages)