Patient Information

Welcome to our clinic!
We want to make your visit as convenient and enjoyable as possible.‍
*All "no-show" appointments will be charged a $20 fee

Online Patient Forms

Save time during your visit by filling out patient forms prior to coming. Forms include patient registration, insurance info, billing procedures and more.

English Forms
Medical History Forms
New Patient Forms
Spanish Forms (Formularios en Español)
Formulario de Historial Medico
Formulario de Pacientes Nuevos

Financial Policies

Insurance: We accept most forms of insurance, including Aetna, Blue Cross Blue Shield, Cigna, United Healthcare, Traditional Medicare, Triwest P3, Texas Medicaid, and Hooray Health. Our office is committed to providing quality and cost-effective healthcare to our patients. It is essential that you understand what services are covered by your insurance plan and obtain all authorizations prior to your appointment. Your doctor may recommend services he/she feels are beneficial but may not be covered by insurance.

It is your responsibility to understand the limit and restrictions affecting coverage for these services. It is your responsibility to provide us with your most current billing information. Insurance reimbursement is a contract between you and your insurance company. As a courtesy to you we file all claims for you.

We will require a current copy of your insurance card in order to do this and will need to be informed of all changes in insurance status. You will be responsible for all co-pays, deductibles, co-insurance amounts along with the entire amount of any non-covered services. Payment for services is expected at the time of service.

Your Visit at the Clinic

Please bring your government-issued photo ID and your insurance card with you when you come to the clinic. When you get here, we’ll need to see both and confirm your birth date.

Your Privacy

Learn how we protect patient privacy at Grand Prairie Urgent Care & Family Medicine.

Click here for our Privacy Policy
We Accept Most Major Insurances


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