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Questions about services? Call (317) 586-8229

Request services

Let’s talk about the support you need

Start with the service you are seeking, the person’s city and county, and the best way to reach you. A member of the Life Choice team will review the inquiry and follow up about provider fit and next steps.

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Before you submit

Please do not include diagnoses, medications, detailed behavior information, risk details, Social Security numbers, Medicaid numbers, or other private health information in this first website message. If additional information is needed, Life Choice will explain the approved secure process.

This form is not monitored for emergencies. If there is an immediate threat to life or safety, contact the appropriate emergency service.

Other ways to connect

Phone

Email

Fax

(855) 586-8221

Address

PO Box 707, Greenfield, IN 46140

Working with a case manager?

Include them in the conversation about authorized services and provider choice. They can also contact Life Choice directly.

About you

Your relationship to the person seeking services
Preferred contact method

About the person seeking services

Service of interest
Payment or waiver option

Consent

Common questions

Questions about contacting us

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