Indiana Professional Psychological Services

Request An Appointment

If you would like to request an appointment, you may submit this secure form, or, call us at (260) 469-0090. While requests cannot be guaranteed, every effort will be made to accommodate your initial request.

For confidentiality reasons, we will respond discreetly to your request only with phone numbers you provide below, or, by regular postal mail.

Your Name
E-Mail
Address or Box #
City, State, Zip
Phone (+ area code)
Alternate phone

I prefer to be contacted by: Phone Regular Postal Mail If by phone, the best time to reach me is:

Is there any day of week you prefer an appointment? (Click those that apply) Any Day Mon. Tue. Wed. Thu. Fri.

Is there any *time of day* you prefer an appointment? (Click those that apply)
Any Time of Day Morning (8:00 am to Noon) Early Afternoon (1:00 pm to 3:00 pm) Late Afternoon (3:00 pm - 5:00 pm)

Brief Comments/Questions:

Please give 24 hour notice of any need to change a confirmed appointment time by calling (260) 469-0090. Thank You!

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Indiana Professional Psychological Services