We ask that all patients arrive 15 minutes prior to their scheduled appointment time to complete all necessary forms and insurance verification. Patients should be accompanied by a parent or legal guardian.
To better serve our patients we ask that you please bring the following to your scheduled appointment:

  • Your insurance card

  • Your co-pay

  • Your completed Registration Packet

  • A list of current medications

INSURANCE
This is a list of insurance companies that we accept.  This is a list of main insurance companies that consider us providers.  We do suggest that all patients contact their insurance to verify that we are on the Provider List.
If your insurance company is not listed we may still be a provider.   Please contact your insurance company to check with their Provider List.

  • AETNA
  • BCBS
  • CIGNA
  • GREAT WEST
  • HUMANA
  • MEDICAID AND MEDICARE
  • PRINCIPAL
  • PRIVATE HEALTH CARE SYSTEMS
  • TRICARE
  • UNITED HEALTHCARE
  • VIVA

*If your insurance requires a referral please have your PCP fax a referral
(205) 558-2055

Click on the image below to print your registration packet.  Bring your completed packet to your first scheduled appointment.

 

Patient Registration Form

    Medical     History Form

Assignment of Benefits Agreement

HIPAA FORM