NeuroHealth Services Indianapolis
  • Conditions We See
    • Concussion and Post-Concussion Syndrome
    • Vestibular Dysfunction
    • Neurobehavioral Disorders
    • Migraines
    • Dystonia
    • Long Haul COVID
    • Dysautonomia
    • Other Conditions
  • Our Approach
    • Free Consultation
    • Discovery Day
    • NeuroReset Program
    • Services
    • Diagnostics
    • Treatment Tools
    • Our Doctors
    • NeuroHealth FAQs
    • Become A Patient
    • Referring Providers
  • Client Speak
  • Resources
    • About Us
    • NeuroHealth Blog
    • New Patient Paperwork
  • Schedule an Appointment

Get In Touch with Us!

Free 10 min consultation

New Patient Paperwork

Please complete this health record to help us understand you and your condition as accurately as possible. If you have any questions, please don't hesitate to reach out to the front desk or ask one of our qualified techs. Please bring along with you on your initial visit any applicable lab work and imaging studies.
It is our pleasure to be of service to you. Our commitment is to provide the highest quality of wellbeing and care. If you have trouble completing this form, please call and we can mail or fax it to you. ​
Picture

Our Doctors

​Dr. Ralston
Dr. Gafken

Learn More

FAQ
Blog
​Contact Us
9302 N. Meridian Street, Suite 299
Indianapolis, IN 46260

​​
(317) 848-6000
Map | Directions

    SignUp FOR OUR NEWSLETTER

Subscribe to Newsletter
© COPYRIGHT 2015. ALL RIGHTS RESERVED.
  • Conditions We See
    • Concussion and Post-Concussion Syndrome
    • Vestibular Dysfunction
    • Neurobehavioral Disorders
    • Migraines
    • Dystonia
    • Long Haul COVID
    • Dysautonomia
    • Other Conditions
  • Our Approach
    • Free Consultation
    • Discovery Day
    • NeuroReset Program
    • Services
    • Diagnostics
    • Treatment Tools
    • Our Doctors
    • NeuroHealth FAQs
    • Become A Patient
    • Referring Providers
  • Client Speak
  • Resources
    • About Us
    • NeuroHealth Blog
    • New Patient Paperwork
  • Schedule an Appointment