Questions About My Bill

By submitting this form, you agree to provide Norton King’s Daughters’ Health with your personal information.
Information on the form will be submitted electronically.

Please use this form to send us a question or concern about your bill. A customer service representative will contact you at the daytime phone number provided within two business days. Should you wish to speak to a customer service representative directly, please call us between 8 a.m. and 4:30 p.m. Monday through Friday at 812.801.0161.

Full Name(Required)

First Last

Patient Name

If different than you

Account Number

Located on your bill

Date of Service

Birth Date

Type of Insurance(Required)

Address(Required)

Street Address Address Line 2 City State ZIP / Postal Code

Email(Required)

Daytime Phone Number(Required)

Question or Message(Required)

Questions About My Bill

Questions About My Bill

By submitting this form, you agree to provide Norton King’s Daughters’ Health with your personal information. Information on the form will be submitted electronically.

Schedule an Appointment

By submitting this form, you agree to provide Norton King’s Daughters’ Health with your personal information.
Information on the form will be submitted electronically.