Policies & Insurance

Policies

As a patient in our practice, you have the following rights, as well as responsibilities that have been listed below. These rights and responsibilities are made with the purpose of ensuring that our practice continues to run smoothly, thus giving us the opportunity to continue to provide a superior level of patient care.

Patient Responsibilities

  • Follow your Physicians instructions.
  • Please be present and on time for all of your appointments. If you are more than 15 minutes late you may have to reschedule your appointment. Please also be advised that a $25 no show fee will be charged for all missed appointments.
  • Let us know if your address, phone numbers or insurance have changed.
  • Carry your insurance card with you at all time and bring to every appointment that you have.
  • Co-payment is due at time of service.
  • Know all of your insurance benefits.
  • If a referral is needed to a specialist let our office know at least 48 hours before your appointment.
  • Allow 48-72 hours for all prescription refills. Call the pharmacy and request a refill on your medication before calling our office.

Patient Rights

  • Receive quality health care.
  • Be treated respectfully by Conroe Family Medicine.
  • Expect that all communications and records pertaining to your health care will be treated as confidential.
  • Take part in wellness programs.
  • Receive assistance from your insurance company’s customer service for concerns and questions.

Insurance Carriers

Conroe Family Medicine welcomes new patients to our practice and is pleased to announce that we accept most insurance carriers for your convenience. Please call our office and our staff will help you determine your patient benefits as estimated by your insurance carrier.

Patient Forms

Don't have time to be here early to complete paperwork? No problem. Print and complete these forms at your convenience and simply bring them along to your appointment. If you do not already have Adobe Reader installed on your Computer, you may click on the link to download it free of charge Download Adobe Reader

New Patient
Registration Form

New Patient
Medical History

Patient Rights
& Responsibilities

Office
& Financial Policies

Notice
of Privacy Practices

Acknowledgement of Notice
of Privacy Practices

Authorization to Release
Health Care Information

Authorization to Treat
A Minor Child