Forms

For first time patients, please print off and fill out the New Patient Forms Packet prior to your visit. 


We do not accept any type of Medicare or Medicare replacement policies


Insurance we accept

Aetna
   Aetna HMO
   Choice Plus POS II

Assurant Health
Blue Cross Blue Shield

   Blue Card PPO
Blue Cross Blue Shield of Texas
   Blue Advantage HMO
   Blue Choice

Cigna
   Cigna HMO
   Cigna PPO
   LocalPlus
   Open Access Plus

Commercial Insurance Company
Coventry Health Care

First Health (Coventry Health Care)
   First Health (Coventry Health Care) PPO
HealthFirst
Humana

   Choice Care PPO
   Preferred PPO

MultiPlan
   MultiPlan PPO
   PHCS Network PPO

Principal Life
Tricare
United Healthcare*
*we do not accept any type of Medicare or Medicare Replacement policies

   Choice Plus POS
   Navigate HMO
   Navigate POS
   Options PPO

*Please verify this information when scheduling an appointment

Things you need before your visit

1. Print and Fill out the Patient Profile Form

This form tells us some basic information about you:

2. Prepare for your Office Visit

In addition to completing the above forms, we will also require the following information for your fist visit:

  • Driver’s License or Other Valid Government-Issued Photo Identification
  • Insurance card and any co-payment due for visit
  • Referral or consultation form if applicable
  • Prior X-Rays, MRI Films, CT Scans, or EMG (please bring the films or CD-ROM containing the images with the paper report)
  • Any pertinent medical history such as lab results
  • Please bring all prescription bottles and supplement bottles you are currently taking.
  • Please note: by law, minors must be accompanied by a parent or guardian.

3. Get Directions to Our Office

Visit our Contact page to find a map of the office where you will see your physician and get driving directions.

4. We Look Forward to Seeing You!

Please arrive at least 15 minutes early if you have not yet filled out these forms. If you have completed forms with you, you only need to check in with the reception desk 5 minutes before your scheduled appointment.

Thank you for your assistance completing this information. We look forward to seeing you on the day of your appointment!

5. Cancellations/No Shows/Rescheduling

Cancellations and rescheduling of appointments must be made with a minimum of 24 hours notice.  No show fees of $25 apply for all cancellations, reschedules and no shows with less than 24-hour notice.