Application for Enrollment

If you are having trouble submitting your application, you might be using the wrong device or web browser:

• Do not use a cellular device or tablet to submit the application.
• Make sure to use the Internet Explorer web browser instead of Chrome, Firefox or another browser.

If you still are unable to submit your application, please contact us for assistance.

Kendra Gilley, Clinical Coordinator

(765) 983-3000 ext. 4767

Kendra.Gilley@ReidHealth.org

or

Chris Werking, Program Director

(765) 983-3000 ext. 3163

Christopher.Werking@ReidHealth.org