Your time is valuable to you. It's valuable to us as well. 

The following forms are required for your first visit.  Please print and complete all 4 forms, or you may arrive 15 minutes prior to your appointment to complete in our office.  

• Welcome Letter
• New Patient Info
• Health History
• Benefit Release
• Representative Authorization

Aetna (Not HMO) Blue Cross Blue Shield Choice Care Network Cigna (Not HMO) Definity Health HealthSmart Health Net

Humana GEHA Great West Galaxy Health Medicare PHCS ppoNext

Texas True Choice TriCare United Health Care (Not HMO) Unicare Workers Compensation Automobile Personal Injury Protection plans (PIP)

* Please note that our insurance plans and networks are continually changing. If you do not see your insurance listed above, please  
  contact our office to see if we accept your plan.

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