5610 Crawfordsville Rd. - Sandra Eskenazi Mental Health Center

Mental Health Services

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STEP ONE:

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STEP TWO: Back To Step 1:

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STEP TWO: Back To Step 1:

This website is NOT for medical emergencies or medical treatment. For medical treatment, please contact your physician’s office by phone or go to the nearest emergency room. For emergencies, please call 911 or go to the nearest emergency room. If this is a mental health emergency, please call 317.880.8485.

Patient Information
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I understand that I am voluntarily disclosing the information above to Eskenazi Health to allow them to contact me. The information I have disclosed is not patient protected information and therefore not subject to HIPAA protection.

Successful submission of this form will take you to a submission thank you page.
If you are not navigated to the submission thank you page, your form was not submitted.

This website is NOT for medical emergencies or medical treatment. For medical treatment, please contact your physician’s office by phone or go to the nearest emergency room. For emergencies, please call 911 or go to the nearest emergency room. If this is a mental health emergency, please call 317.880.8485.

I understand that I am voluntarily disclosing the information above to Eskenazi Health to allow them to contact me. The information I have disclosed is not patient protected information and therefore not subject to HIPAA protection.

Successful submission of this form will take you to a submission thank you page. If you are not navigated to the submission thank you page, your form was not submitted.
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