Adult new patient packet
Required for all new primary care patients 18 and older. Submit it before scheduling your first appointment.
Patient forms
Get your paperwork done before your first visit
Every new primary care patient completes a packet before we schedule an appointment. Fill it out online, or print it and drop it off or fax it to us.
Call first to confirm we're taking new patients. We may stop accepting new primary care patients at any time. Call 409.210.3336, or type "new patient" in the Facebook chat on our homepage.
How it works
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STEP 1
Call to confirm
Make sure we're accepting new patients before you start your packet.
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STEP 2
Complete your packet
Use the online form or the printable PDF. Adults 18+ and children have separate packets.
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STEP 3
Send it with your insurance card
Include a copy of the front and back of your card. Drop it off at the clinic or fax it.
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STEP 4
We'll call you
Processing takes 4–7 business days. Once it's done, we call to schedule your first appointment.
Find your form
Online forms are in beta. If anything gives you trouble, let us know or use the printable version instead.
Child new patient packet
Minors can become patients when their parent or guardian is also a patient here.
Wellness new patient packet
For wellness services only, if you aren't already a primary care patient. Covers Biote® hormone therapy, DermaSweep, and ED treatments.
Annual update packet
Haven't been seen yet this calendar year? Fill this out ahead of time and save time at check-in.
Reforming Life new patient packet
Complete this before your Reforming Life consult so we can get you in and out of the office quickly.
HeartSmart patient packet
Complete this paperwork before your HeartSmart cardiovascular exam.
Medical records consent
Use this to have your records transferred to us from another facility or doctor.
Notice of Privacy Practices
How we protect your personal health information, and when and how it may be disclosed.
No forms in this group.
Send in a printed packet
Online forms come straight to us. For printed packets, drop them off or fax them. For your privacy, we can't accept forms by email.
Drop off
2927 Nall Street
Port Neches, TX 77651
Bring it to the front desk during office hours.
Get directionsFax
409.527.3969
Include every page plus your insurance card.
- Every page of the packet is complete and signed
- A copy of the front and back of your insurance card
- A phone number where we can reach you to schedule
- Allow 4–7 business days for processing
Not sure which form you need?
Call the front desk and we'll point you to the right packet. Wellness visits for Biote® and ED treatment use a separate cash-pay packet.