General Forms & Requests

What To Bring Checklist

  • Insurance Card
  • Any Updated Patient Information
  • A list of all medicines; prescription and over the counter (name, dose, and frequency taken) that you are currently taking.
  • A list of any medications that you have allergies to or have experienced an adverse reaction to in the past.
  • Any documents that might be pertinent to your treatment (previous psychological testing, hospital discharge summaries, recent laboratory results, etc.).

Insurance & Billing

Our website is under construction and we are unable to accept online payments at this time.  We’re sorry for an inconvenience this has caused.

Please contact our office at 812-401-8008 to make payments on your account.

Doctor's Refer A Patient

Our website is under construction and during this time we are unable to accept referrals via this website.
Please contact our office 812-401-8008 for a referral form to start this process.

1st TIme Office Visits

Are you a new patient that is wants to be prepared the first time you come into our office? Please visit the following page to fill out all the necessary forms and get your list of items to bring to our office.

Interested In Becoming A Patient?

General Forms & Requests December 2, 2014