Refer a Patient

Thank you for referring your patient to Indy Advanced Therapeutics. We are committed to providing all individuals with the highest level of care and respect. Our providers are committed to helping you and your patients with their mental health needs.

In order to access the Physician Referral Form, please click on the link provided: Physician Referral Form

In order to access the Consent to Treatment Form, please click on the link provided: Consent to Treatment

Once you have downloaded the forms, you may return the completed form with a completed consent to treatment form by fax, 317.818.9009, or by email, ketamine@indyat.com.

If you have any questions concerning the referral process or the referral form, please contact us at 317.899.9362.