New patients are expected to complete and submit the following forms.
Click the appropriate link below. You can print out at home and bring
to your first visit.
Aetna Medicare (Starting Jan 1, 2024)
Avmed Medicare
AARP secondary (NOT AARP Medicare Complete)
Devoted
FL Blue Medicare HMO/PPO, Premier HMO and Classic HMO
Humana Medicare/Humana Medicare PPO
Medicare
Medica
MMM
Preferred Care Partners
Commercial Plans
Aetna
Anthem
Aliera Healthcare/PHCS
Assurant Health
Avmed – Engaged, Empower (NO AVMED ONE)
Cigna (NO LOCAL PLUS)
Empire PPO
First Health
Florida Blue – BlueOptions plans, Bluecare HMO,Horizon (NO MYBLUE/NO BLUESELECT)
Fringe Benefit Group – FBG
GEHA ( through Aetna)
GHI PPO
Golden Rule ( through UnitedHealthCare)
Guardian
Humana PPO, HMO Premier, National POS, Open Access
Liberty Health Share
Multiplan/PHCS
Memorial HMO & PPO plans
Meritain Health ( through Aetna)
UMR (through UHC)
UnitedHealthcare Neighborhood Health
Unitedhealthcare- Oxford (Choice plus, PPO)
