How do I Get on the Waiting List?

Contact us:

info@peakcommunity.com

Here's what you'll need to take:

1) Name and contact information for the person needing to get on the list.

2) Besides yourself, know the name and phone number of a person who will know how to reach the person several years from now.

3) Physician names and contact information.

4) Know approximately when the person last saw each physician and for what reason.

5) The person's Social Security number.

The process only takes about 20 minutes. Please contact us with any questions you may have. And don't delay! The State of Indiana's waiting list will only get longer. Call today!

Waiting List Form

Name:

(Day) Phone:

Email:

Comments:

Verify: