Locations Opportunities

Additional Forms

Once you have downloaded the form you need, please complete it and return to:

Mid America Health, Inc.
Attn: Human Resources
1499 Windhorst Way, Suite 100
Greenwood, IN 46143
Toll Free: 1-888-309-8239
Fax: 1-317-972-7969

Forms Available for Download

2012 Payroll Periods –

2012 Department Of Corrections Bi-Weekly Payroll Periods 

 2012 Payroll Periods – FEDERAL

 2012 Semi Monthly Payroll Periods

2012 Commision Semi Monthly Payroll Periods

Federal Employee Time Sheet – Federal Timesheet and Instructions

Employee – Portable/Corrections Timesheet – One Week | Two Week

Expense Report – PDF | EXCEL

PrevMED Expense Report - MAPG Expense Report-PrevMED 

W4 Form

Direct Deposit

I9-Form

Indiana WH-4 Tax Form

Ohio IT4 Tax Form

California DE4 Tax Form

401 K Summary Plan (updated version)

401 K Change or Suspend Contribution Form – Complete Section A, B, C, and E Completely if applicable.