Same-Day MVA Appointments Available — No Insurance Required | Lien-Based TreatmentPatient Forms in Merrillville, Indiana
Merrillville Injury Care provides patient intake forms and documentation to help streamline your first visit. Completing these forms in advance saves time and ensures our medical team has the information needed to begin your evaluation promptly.
New Patient Forms
New patients should complete our patient intake form, medical history questionnaire, insurance information form, and authorization and consent documents before their first appointment. Forms are available at our office or can be requested by calling (866) 264-0827. Completing these forms before your visit allows us to maximize the time spent on your evaluation and treatment.
Lien-Based Treatment Documentation
Patients receiving treatment on a medical lien basis will need to complete additional lien agreement documentation, which is coordinated between our office and your attorney. Our staff handles the preparation and processing of lien documents to ensure treatment can begin without delay.