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How to Order Brochures

What You Need To Know

  • There will be no charge to you for the brochures and forms
  • The Hoosier Healthwise Brochures come in packets of 100
  • Hoosier Healthwise for Children - List of Benefits and Co-Pays (English) 
    Form number OMPP0012 (R5 -4/04) (in PDF)
  • Hoosier Healthwise for Children - List of Benefits and Co-Pays (Spanish) 
    Form number OMPP0012S (R5 -4/04) (in PDF)
  • Hoosier Healthwise (purple) application form (English)
    Form number 43202 (R3/1-00) (in PDF)
  • Hoosier Healthwise (purple) application form (Spanish) 
    Form number 48974 (R /1-00) (in PDF)
  • Brochure stands/literature holders - form number NN 132

To order brochures or brochure holders, Please follow these instructions:

If you are a state agency
Complete a Request For Distribution of Forms and Publications - State Form 1140 (R4/7-95) and follow the normal procedures for ordering forms through the Department of Administration (317-591-5228), including the quantity being requested.

If you are not a state agency
Draft a letter (on your agency stationary) to the Department of Administration Forms Distribution Center at the following address:

    Department of Administration
    Forms Distribution Center
    6400 E. 30th Street
    Indianapolis, Indiana 46219

Make sure you include in the letter:

  • The number of brochures or forms you are ordering (in quantities of 100)
  • The form numbers are different for English and Spanish versions
  • The name of the brochure or form
  • The name of a contact person in your agency and phone number in case the distribution center needs to contact you.

If you need to contact the Distribution Center, the number is (317) 591-5228.

Other Materials
There are other brochures that are not available from the State Distribution Center but may be available in limited quantities by contacting a Hoosier Healthwise Provider Services Representative, a Hoosier Healthwise Benefit Advocate, or the Hoosier Healthwise Helpline at 1-800-889-9949.

  • Choose Your Own Doctor - brochure
  • Emergency Room education - brochure
  • Hoosier Healthwise Helpline - card
  • Hoosier Healthwise Helpline - (yellow) magnet