Patient information

Accepted Insurance Plans

PPO Plans

Aetna

Beech Street

Blue Cross

Humana

Cigna

Coventry

First Health

Healthsmart

Multiplan

PHCS

United Healthcare

Ambetter

HMO and Medicare Plans

Aetna/Aetna Medicare Advantage

Blue Cross HMO and Medicare Advantage Plan

Humana Medicare Advantage

Wellmed

Southwest Health Resources

Texan Plus

United Healthcare/United Healthcare Medicare

Traditional Medicare

VA CCN

Triwest

Ambetter HMO

***We do not except Medicaid

To schedule, call our office at (817) 481-7727

Please arrive for your appointment 15 minutes prior to scheduled time

What to Bring to Your Appointment

Completed paperwork
Insurance card
Identification
List of current medications
Referral if required by your insurance
Medical records that may be pertinent
Payment for services rendered

Cancellation Policy

If you must cancel or change your appointment, please give us at least a 24 hour notice.

PATIENT PAPERWORK

NEW PATIENTS

Please print all forms, complete and bring to your appointment.

DEMO SHEET (pdf)

Download

MEDICAL HISTORY (docx)

Download

PHARMACY FORM (docx)

Download

FINANCIAL POLICY (doc)

Download

NON PARTICIPATING INSURANCE (docx)

Download

NOTICE OF PRIVACY PRACTICES (docx)

Download

Auth for Use or Disclosure of PHI (pdf)

Download