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Your Visit

 
 
 
 
 

*NEW PATIENTS: Please print and fill out the patient forms below and bring to your appointment OR plan to arrive 30 MINUTES BEFORE your appointment time to complete paperwork*

*ESTABLISHED PATIENTS: Please arrive 15 minutes early to update your information*


Participating Insurance Plans:

Aetna
Blue Cross Blue Shield
Cigna
Humana
Medicare
Private Healthcare Systems
Tricare
United Healthcare


Patient Forms:


Registration

-English
-Spanish

Privacy Agreement

-English
-Spanish

Payment Policy 

-English
-Spanish

Credit Card Authorization

-English
-Spanish

Release of Medical Records

-English
-Spanish
-Parkland Release Specific
-English
-Spanish

Cancer Screening Questionaire

-English
-Spanish

Phone:
214-879-8585

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