Forms

New Patient Referrals

Click here if you would like to refer a patient to our practice. To streamline the process please have the person you are referring complete the New Patient Scheduling form below.

New Patient Scheduling

Thank you for considering IHG while seeking behavioral healthcare services.  To serve you more efficiently, we have recently implemented a secure online New Patient Scheduling Form to begin the process. This form takes approximately 3-5 minutes to complete.

We are hoping this will allow us to connect with you quicker and accommodate more patients over the course of a day. Previously this process was handled completely over the phone from start to finish, on average this call would take 20-30 minutes following several rounds of telephone tag before connecting. This is frustrating for everyone!

We value your time!  The more information we can collect from you via this online form will significantly reduce the call time by allowing us to complete the data entry and compile suggestions for providers that match your individual needs prior to the call. Please follow the steps below.

Step 1: Click here to complete our New Patient Scheduling Form.

Step 2: Once you submit the New Patient Scheduling Form above, we will contact you to schedule your appointment. During this call you will also be given an access code and instructions for our secure patient portal.

Step 3: Once you receive your access code for the patient portal click here  to complete the remainder of the New Patient Registration process.

If you are unable to complete the remainder of the New Patient Registration through the portal you will need to arrive no later than 30 minutes prior to your scheduled appointment time. We reserve the right to cancel your appointment if your registration is not complete by the time of your appointment.

Patient Portal

If you are already a patient and do not currently have access our secure patient portal, please contact our office at 317.843.9922. You will be given an access code and instructions to navigate the portal.

If you have already set up your account with us on My Medical Locker you can click here to access the portal!

Applied Behavioral Analysis (ABA) Group Interest

If you are interested in one or more of our ABA Groups please complete our “ABA Group Interest Form” and one of our Board Certified Behavior Analyst will be in touch soon!

Release of Information Forms

Other Forms

Patient Satisfaction Survey

  • Your feedback is important to us.  Please click here to complete our confidential patient satisfaction survey.  Thank you!