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Partial List of Contracted Insurance Companies


Aetna
Anthem
Assurant
Blue Cross
Cigna
Encore
Humana
IU Health
Medicare
Medicaid Traditional
PHCS
Sagamore
Tricare
UMR
United Healthcare

New Patient Forms


Welcome to BalanceMD
Patient Information Form
Medical History Form
Financial Policy
Signature Form



Vestibular Function Testing Information


Vestibular Test Instructions

VEMP Information



Virtual Visit Forms


Private Insurance - Initial Visit Forms
Private Insurance - ABNfor subsequent visits
Medicare - Initial Visit Forms
Medicare - ABNfor subsequent visits

Patient Forms