NEW PATIENT FORM

 

INSURANCE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ASK AWAY VIDEO SERIES

If you are a new patient, please fill out this form and bring to your first appointment.  You can also come in fifteen minutes prior to your appointment to fill it out at the clinic. Also take a look at our Privacy Practices.

 

Below is a list of insurance companies we are currently in-network with. Even if your insurance company is not listed, we can still work with you.  Please phone our office at 260-739-0300 with any questions you may have about being in network or coverage benefits.

  • AARP

  • Align networks

  • Ambetter

  • Anthem Blue Cross Blue Shield

  • Anthem Medicaid

  • Coventry health care

  • Hoosier Care Connect

  • Hoosier Healthwise

  • Medicaid

  • Managed Health Services

  • MDWise

  • Medicare

  • MHS Indiana

  • Physicians Health Plan (PHP)

  • Three Rivers Provider

  • Tricare

  • United Health Care (UHC)

  • Workers' Compensation

 

"Ask Away" videos give brief answers to questions Dr. Evans commonly hears.  If you have a question you'd like answered in this video series, reach out to us on Facebook or directly message us through the Contact Us  page on this website.