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(817) 898-2188
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Download & Print Patient Forms
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.
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 PPO / HMO
Aetna Medicare PPO and HMO
Aetna - Texas Health Aetna
Aetna Medicare Advantage PPO / HMO
Anthem Blue Cross
BlueCross BlueShield HMO / PPO
BlueCross BlueShield Medicare Advantage HMO / PPO
Cigna PPO / HMO / OAP (Not in network with Local Plus Plan)
Humana Choice Care PPO
Humana Medicare Advantage Choice PPO
Humana Medicare Advantage Gold Choice PFFS
Humana Medicare Advantage Gold Plus HMO
Medicare Part B
Railroad Medicare
Multiplan Complimentary Network
United Healthcare PPO / HMO
United Healthcare Medicare Advantage
UMR
Insurances Not In-Network
Medicaid - Star, Amerigroup, CHIP
Wellpoint
Wellcare MA HMO/PPO
Blue Cross Blue Advantage HMO
Blue Advantage Plus HMO
MyBlueHealth
Cigna Local Plus
Oscar
Ambetter
Care N’ Care
Molina
Tricare (only if primary insurance)
ChampVA
PHCS
Coalition America
Galaxy PPO
Health EZ
Healthcare Highways
Healthsmart ACCEL
Healthsmart GEPO
Healthsmart PPO
IMS PPO
USA MCO
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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