Please print and fill out these patient forms. Bring the completed patient form to the facility on the date of your appointment

Please print and fill out these patient forms. Bring the completed patient form to the facility on the date of your appointment:

Patient Intake Form

Privacy Form

HIPAA Request Form

New Patient Intake Form

Notice Of Privacy Practices

Medical Records Request Form

INSURANCES

Our Providers are in NETWORK with most of the insurances.

  • Medicare
  • Most Medicare Replacement plans
  • Blue cross blue shield
  • Aetna
  • Humana
  • OPTUM- United behavioral health
  • Cigna
  • Cigna Health Spring
  • WellCare
  • Magellan
  • Value Option
  • Any many more !

Please call office for more information 281-481-4646