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NEW PATIENT CHECK-IN PACKET

NEW PATIENTS: Please complete and bring this packet prior to arrival so that we can help expedite your visit.  Arrive 15 minutes prior to scheduled appointment.

Bring the following with you:

- The above completed new patient form

- Form of picture identification (driver's license)

- Your insurance card if applicable

- Medication list (can be listed on the check-in form, or separately)

- Form of payment

 

If your insurance requires a referral from your primary physician, you will need to have your PCP send us the referral to allow us to see you.

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Please plan to arrive 15 minutes prior to your scheduled appointment time.

We try to keep this list updated, however because of frequent changes in the insurance market there may be changes not reflected on this list. Please contact us to see if your plan is covered.
Please call us for details if you don't see your insurance listed or are not currently on an insurance policy.
We currently accept the following insurance plans:

Aetna - Texas Health Aetna
Aetna PPO / HMO
BlueCross BlueShield HMO / PPO / FEP
BlueCross BlueShield Medicare Advantage HMO / PPO
Cigna PPO / OAP / POS / HMO
Galaxy Healthcare Network PPO
HealthEZ
HealthSmart
Humana Choice Care PPO
Humana Medicare Choice PPO
Humana Medicare Gold Choice PFFS
Humana Medicare Gold Plus HMO
IMS PPO
Medicare Part B
Multiplan Network
USA Managed Care Organization
United Healthcare HMO Select
United Healthcare Medicare Advantage
United Healthcare PPO
Zelis

Don't have a login? Call us.
You should receive login info once you register
with our front desk via phone or in-person.
Insurances

Insurance Plans Accepted

Other Forms

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