Information You Need

Need a Form?

  1.  New Patient Registration Form  New patients or patients whose information has changed since your last visit should fill out this form before a visit.
  2.  Initial Patient History Form  New patients should fill out this before your first visit.
  3. Authorization for Release of Protected Health Information
  4. Our Financial Policy
  5. Notice of Privacy Practices
  6. Written Acknowledgment of Receipt of the Notice of Privacy Practices
  7. Consent for Medical Treatment of a Minor Child
  8. Advanced Beneficiary Notice (ABN)
  9. Family History Questionnaire For Cancer Risk


  • Call Us: 317-893-3131
  • Fax it To Us: 317-893-2445

Name (required)


Your Email (required)

Subject (required)

Your Question

Type the letters/numbers in the box below


Important Note: email contact is for regular communication only. DO NOT use email for emergencies. We normally respond to email within one business day.

Insurance Accepted – NOTE: Changes Frequently

With the implementation of the Affordable Care Act insurance providers are changing more rapidly than ever. This list may contain companies that we no longer work with or companies may have added Dr. Davidson and this list does not reflect those changes yet.

Please contact our office, 317-893-3131, to confirm that your insurance is accepted. If you do not have insurance please contact us about payment plans if you need care and are concerned about your ability to pay.

  • UHC Choice Plus POS
  • UHC Options PPO
  • United Healthcare EPO
  • United Healthcare HMO
  • United Healthcare POS
  • Aetna Choice PPO
  • Sagamore Plus
  • Sagamore Plus Network PPO
  • First Health PPO
  • Humana Choice Care Network PPO
  • CIGNA Open Access
  • BCBS Blue Card PPO
  • Multiplan PPO
  • Aetna PPO
  • Americas Health Plan HMO
  • Federated PPO
  •  Anthem