Therapy Referral Form

To obtain therapy services please email this form to or fax to (317) 203-0955. Once we verify eligibility we will contact you to begin services. If you have any additional questions or concerns feel free to contact us via email here or call (317) 296-4187. We accept Medicaid, Hoosier Healthwise, HIP, HIP 2.0, Medicare, most private insurances and self-pay.

Cafe Information Reqest

If you are interested in Cafes or having us come to host or consult with your organization on building a cafe program please contact our Cafe Director Kyle Fisher. We offer everything from hosting cafes to training staff within an organization on building a program or offering consultation on marketing, programming and developing cafes programs within the community.

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Call us today (317) 296-4187

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