2013 HIPAA Notice of Privacy

MEDICAL & DENTAL insurances we accept:

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.)

How to become a new patient with us:

Download and print the appropriate medical or dental patient intake form.  Follow instructions for each.

• MEDICAL Form (PDF):  7 pages.  Open in Internet Explorer.   Complete this form prior to your first medical visit.  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.  Completing the form from home will save you time at the clinic.
  
  
• DENTAL Form (PDF):  7 pages.  Open in Internet Explorer.  Complete this form prior to your first visit for dental services to either our Panama City or Freeport facility.     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.

MEDICAL Form (PDF):  7 pages.  Open in Internet Explorer.

DENTAL Form (PDF):  7 pages.  Open in Internet Explorer.

Clinics by City:

(In case of an emergency, call 9-1-1)

      Blountstown:

• (Medical Clinic):
  PanCareHealth
  16875 North  Cayson Street, 32424
  (850) 674-2244 / FAX:  (850) 674-2249

     Bonifay

• (Medical Clinic):
  PanCare Health
  495 St. Johns Road, 32425
   (850) 547-5547 / FAX:  (850) 547-5553

     Bristol

• (Medical Clinic):
  PanCare Health
  11033 NW State Road 20, 32121
   (850) 643-1155 / FAX:  (850) 643 -1163

     Bruce

• (Medical Clinic):
  Muscogee Tribal Health Center
  278-A Church Road 
  (850) 835-1015 / FAX:  (850) 835-1055

     Chipley

• (Medical Clinic):
  PanCare Health
  1414 Main Street, Suite 4, 32428
  (850) 676-4926 / FAX:  (850) 676-4929

     Freeport

• (Dental Clinic):
  PanCare Health
  479 East Highway 20, 32439
  (850) 880-6568 / FAX:  (850) 880-6583
  
  
• (Medical Clinic):
  PanCare Health
  479 East Highway 20, 32439
  (850) 880-6568 / FAX:   (850) 880-6583

     Panama City

• (Dental Clinic)
  Community Health Center,
  707-A Jenks Avenue, 32401
  (850) 767-3350 / FAX:  850-747-3353

• (Medical Clinic):
  Community Health Center,
  2309 East 15th Street
  (850) 747-5272 / FAX:  850-747-5274