Patient Forms | Porter Trust Employee Health Clinic

844-458-2800

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Authorization to Release Healthcare Information

Clinic - HIPAA Form

Notice of Privacy Practices

Patient Rights Request Form

Clinic Locations

307 Carlson Dr.
Knox, IN 46534

8688 Broadway
Merrillville, IN 46410

2801 Bertholet Blvd, Suite 201
Valparaiso, IN 46383

Administrative Building 1401 144th St.
East Chicago, IN 46312

411 S 5th Street
Chesterton, IN 46304

To Schedule An Appointment

Call: 844-458-2800
Fax: 219-224-2315 (Knox)
Fax: 219-224-2314 (Merrillville)
Fax: 219-224-3237 (Valparaiso)
Fax: 219-209-9704 (Virtual Clinic)
Fax: 574-207-4228 (Duneland)

After-Hours Hotline

Call: 877-768-0082

Please use this hotline only for your urgent needs when your clinic is closed.
If it is during regular clinic hours, please call your clinic directly.