Refer a Patient
We provide convenient, timely access for our patients through multiple locations in greater Indianapolis and central Indiana. We ensure fast feedback to referring physicians to assist in providing a total care program.
When the need for specialty neurological care arises, Indiana Neuroscience Associates will deliver high quality, comprehensive and cost effective care.
To refer a patient, just download “Referring Physicians Form PDF” (280 KB)
Release of Information
A “Personal Party Release of Information” must be completed to allow Indiana Neuroscience Associates to discuss appointment scheduling, billing, insurance, and treatment plans, etc. with designated family members, parents, guardians, and other personal parties, etc. A release is not required for parents/guardians of children under the age of 18.
A “Professional Release of Information” must be completed to allow Indiana Neuroscience Associates to send records, obtain records, or share information with other professional individuals, etc. A separate release is required for each individual and/or organization.
Download the Release of Information Request Form PDF (43KB)
THESE ARE SUBJECT TO CHANGE WITH EACH OF OUR PHYSICIANS AND OFFICES. YOU MUST VERIFY WITH YOUR SPECIFIC INSURANCE COMPANY.
Indiana Health Network
Intergrated Health Systems
Managed Health Services MHS
One Call Medical
Private Healthcare Systems PHCS
Southern Indiana Health Organization SIHO
St. Francis Health Network
St. Vincent Health Network
United Health Care UHC