Patient Resources

New Patient Forms

Please download and complete the New Patient Form and Health History Questionnaire (ONLY), fax the forms to (972) 964-0562 and bring the original forms with you on your first visit.

Hearing Assessment

Tinnitus Questionnaires

On your first visit, please remember to bring …

• your insurance card
• a picture ID, such as driver’s license
• referral form(s), if required by your insurance company
• copies of any x-ray films or CD’s associated with your condition
• copies of hearing tests or hearing aid information, if available

If you are scheduled for allergy testing, do not use any antihistamines 72 hours prior to the test and do not wear any perfume the day of your test.

Financial Policy

Please call us at least 24 hours before your appointment time if you need to reschedule, change or cancel an appointment. A $25.00 charge will be applied for any appointment that is not canceled at least 24 hours prior to the appointment time. A deposit of $200 may be required for all surgical appointments. If the appointment is missed and not canceled at least 24 hours before the appointment time, the deposit will not be refunded.

• A variety of commonly asked Financial Policy questions.

You will be prompted to enter your Statement ID and Access Code that comes on your statement. 

Privacy Practices for Protected Health Information

• Download our PDF outlining our Notice of Privacy Practices (pdf)

Participating Insurance Providers

• AARP United Healthcare
• Aetna-HMO and PPO
• Baylor Scott & White
• BlueCross BlueShield-PPO, Federal, HMO Blue
• Beech Street-PPO and Member works
• ChoiceCare-PPO
• Cigna-PPO, POS and HMO
• Community Health Plan-PPO
• DART Health Plan
• First Health Network-PPO
• Galaxy Health Network-Med Savings Card
• Galaxy Health Network-PPO
• Golden Rule
• Great West Group and Pension
• Healthsmart Preferred Care-PPO
• Humana- HMO and PPO
• Medicare
• Multiple Medicare replacement plans
• Mutual of Omaha
• NTHN
• One Health HMO/PPO
• Pacificare-PPO and HMO
• PPO Next
• Private Healthcare Systems (PHCS)
• ProNet PPO
• Secure Horizons
• Texas True Choice-PPO
• UMR
• Unicare PPO
• United HealthCare-PPO, POS and HMO
• USC HealthServices-PPO

Plans that require a referral from your primary care provider:

• All HMO plans
• Medicare replacement plans
• Secure Horizons

We are not providers for any insurance plans on the exchange program except Blue Cross Blue Shield and United HealthCare Compass plans. Both plans require a referral from your primary care provider.

Please contact your insurance plan provider for verification and additional details.