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 patients newborn to 18 years. 


Dr. Colleen Bingham is accepting newborn applications ONLY

Dr. Michael Brummer is no longer accepting applications.


Dr. Jeffrey Brummer is accepting newborns to seniors. 


Dr. Jeffrey Crowell is accepting newborn to seniors. 

Dr. Thomas Heischmidt is accepting newborns. 


Thank you!

Phone: (217)342-7000
Fax: (217)342-7002

  • Mon-Thurs: 7am - 6:30pm
  • Friday: 7am- 5pm
  • Sat: 8am - 10:30am