Patient Forms

Complete the forms below to begin services with the
Porter-Starke Services team.

New Patient Forms

Thank you for trusting Porter-Starke Services with your healthcare needs. Our knowledgeable and compassionate team is dedicated to providing the best service to our community. To begin treatment, please complete and sign the following forms. Our intake specialists will advise you on the best way to return these forms.

To view, print, or download, please click on the form title.

Ready for Help? Contact us today.

Crisis Line: 219.531.3500 | Medical Emergency: Dial 911

Valparaiso Campus
601 Wall St.
Valparaiso, IN 46383
219.531.3500

Knox Campus
1001 Edgewood Dr.
Ste. 1
Knox, IN 46534
574.772.4040

Portage Campus
3176 Lancer St.
Portage, IN 46368
219.762.9557

Marram Health Center
3229 Broadway Ave. 
Gary, IN 46409
219.806.3000

Marram Health Center
704 S State Road 2
Hebron, IN 46341
219.996.2641