Below is a list of hard-copy forms you can download, fill out, and fax or mail to INHP.
Our main fax number is 317.610.4600.
Our mailing address is: 3550 N. Washington Blvd., Indianapolis, IN 46205
To request services in English, please print, fill out the form, then fax to the above number.
Click here to download the English "Request for Services" form.
Para solicitar servicios en español, imprima y llene la forma e envíe por fax al 317.610.4600.
CRS form español (Oprima la tecla derecha y seleccione )