Thank you for your submission!

 

 

Your intake form has been received.

 

Next steps:

1. Request an appointment – If you haven’t already, please request an appointment and we will get back to you shortly to confirm an available date and time.
2. We will need your insurance information – Provide insurance information when we call
3. Appointment visit – Please arrive early so that we can complete your initial processing. Also, please bring the following:
   • Photo ID
   • Patient’s insurance card
   • Recent test results, x-rays, or relevant records

 

If you have any questions, please call us at Bloomington (812) 333-4422, Bedford (812) 277-1000 or Washington (812) 254-2911.