MEDICAL & DENTAL Services

For MEDICAL services, we accept:

• Medicaid
• HealthEase Medicaid
• Staywell Medicaid
• Wellcare
• Prestige
• Medicare
• Blue Cross/Blue Shield
• No insurance?   Payments on a sliding scale for those who do not have insurance. Must bring proof of household income (food stamp letters, pay stubs, tax forms, prior year returns, letters from employers.)

For DENTAL services, we accept:

• Delta Dental
• Cigna
  
• MetLife
• Medicaid for adults
• DentaQuest or MCNA (Medicaid for children)
• No insurance? Payments on a sliding scale for those who do not have insurance. Must bring proof of household income (food stamp letters, pay stubs, tax forms, prior year returns, letters from employers.)

In Case of a
Medical Emergency:
Dial 911

2013 HIPAA Notice of Privacy

MEDICAL FORM (PDF): 7 pages.  Open with Internet Explorer.  Complete this form prior to your first medical visit.

DENTAL FORM (PDF): 7 pages.  Open with Internet Explorer.  Complete this form prior to your first visit for dental services to either our Panama City or Freeport facility.      .

Instructions:

1. Medical Patients:  After you’ve completed your form, call us to schedule your first appointment at the facility of your choice on the center of this web page.  We’ll instruct you on additional documents you may need to bring.

1. Dental Patients:   We need your completed form BEFORE we can make your first appointment.  Fax the completed form to us or mail/deliver to the facility at which you wish to make your appointment listed in the center of this web page.