Contact Us

Indianapolis

Indiana Developmental Training Center

11075 North Pennsylvania Street
Indianapolis, IN 46280
317.815.0505
Fax: 317.815.1645
E-Mail: admissions@idtc-in.com

Lafayette

Indiana Developmental Training Center

3700 Rome Drive
Lafayette, IN 47905
765.448.4220
Fax: 765.448.4217
E-Mail: admissions@idtc-in.com


 

Online Referral / Information Form

To make a formal referral, receive additional information or get on our mailing list, please fill out the information form below and click "submit" or contact an Admissions Specialist at 317.815.0505 (Indianapolis) or 765.448.4220 (Lafayette). (* = required field)

Information about the person you are referring
 

*Name of Person You Are Referring: Gender: Male  Female

Date of Birth:

 


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*Your Agency:
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Brief Description of Concerns or Information Requested:


Quick Links

Download Referral / Information Form
Print this Form and mail or fax it to:

(Indianapolis) 317.815.1645
11075 N. Pennsylvania St.
Indianapolis, IN 46280
or
(Lafayette) 765.448.4217
3700 Rome Drive
Lafayette, IN 47905

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Download Map to IDTC - Lafayette
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