Patient Information


 

Forms

For our new patients – please print out and complete the following forms to bring to your first visit. This will expedite your check in process when you arrive at the clinic. Remember to bring your insurance card(s) and picture ID to be entered into our computer system at your visit.

New Patient Hist- Adults

Patient Info Form - Adults

Patient Info Form - Child 

Privacy Policy

Financial Policy Form

Payment Policy Form

Release of Records

 

ADD/ADHD Forms Page


Insurances

Please contact our Billing Department if you do not see your insurance listed below. We do accept many other insurance companies not listed below.

  • » MEDICARE
  • » MEDICAID
    •       - Traditional Medicaid
    •       - Amerigroup
    •       - Community Health Choice
    •       - Molina Healthcare
    •       - United Healthcare
    •       - Superior
    •       - Texas Children’s Health Plan
  • » AETNA HMO AND PPO
  • » BEECH STREET
  • » BLUE CHOICE
  • » BLUE CROSS BLUE SHIELD (HMO AND PPO)
  • » CHIPS
    •       - United Healthcare
    •       - Texas Children’s Health Plan
  • » CIGNA HMO AND PPO
  • » GREAT WEST HEALTHCARE PPO
  • » HEALTH FIRST
  • » HEALTH SELECT
  • » HEALTHSMART PREFERRED CARE
  • » HUMANA PPO (INCLUDING MEDICARE PPO)
  • » MULTIPLAN
  • » PHCS
  • » TRICARE/HUMANA MILITARY HEALTHCARE
  • » UNITED HEALTHCARE
  • » UMR/WAUSAU

 

 

Our Locations

Choose your preferred location