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