Affiliatesoffamilymedicine.com

Affiliates of Family MedicineHome

WebSPRING: 28517 Spring Trails Ridge, Suite 100 Spring, TX 77386 Phone: 281-362-5436 Fax: 281-651-5451

Actived: 9 days ago

URL: https://affiliatesoffamilymedicine.com/

Affiliates of Family MedicineOur Services

WebManagement of Diabetes, High Cholesterol, and Thyroid Disorders. Dietary and Wellness Counseling. Help with Depression and Anxiety and much more! We Also Provide Special Services Such As: Mole Removal. Ingrown Toenail Removal. Bioidentical Hormone Replacement. Joint Injections. Sebaceous Cyst Excision.

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Affiliates of Family MedicineNutritional Supplements

WebNutritional supplements are part of the overall picture of your healthy body. As part of your team for a long and healthy life, we are excited to offer nutraMetrix™ Advanced Nutraceuticals, a comprehensive nutrition based program that is …

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Affiliates of Family MedicineAbout

WebAbout. Office Hours: Our normal office hours are 7:30 am -5:00 pm Monday thru Thursday & 7:30 am -3:30 pm on Fridays. For minor emergency needs after business hours (which cannot wait until the office re-opens), you may call our office and the answering service will have the physician-on-call contact you. “Please note that there may be a

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Bios Life Slim Weight Loss

WebThe innovative Bios Life Slim program contains natural ingredients that not only radically burn fat, but also help your body regulate the amount of fat that it stores. Some of the other benefits of the Bios Life Slim® from Conroe Aesthetics and Wellness are. Reduced glycemic index of foods you eat. Improved cholesterol levels.

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Affiliates of Family MedicineFAQ

WebWe accept VISA, MasterCard, personal checks and cash payments. Should you have a question regarding your account, please contact our billing representative at (936)788-1060.

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3 Preventitive & Diagnostic Labs

WebAlso Called a “Physical”, “Wellness Exam” or “Annual Exam”: A preventive exam is a scheduled medical evaluation of an individual that focuses on preventive care. It will include an age and gender specific history, an examination, a review of risk factors and the ordering of appropriate immunizations, screening labs or diagnostic

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AFFILIATES OF FAMILY MEDICINE, P.A.

WebAFFILIATES OF FAMILY MEDICINE, P.A. Patient Centered Medical Home Patient Compact A Patient Centered Medical Home is a trusting partnership between a doctor-led healthcare team and an informed patient.It includes an agreement between the doctor and the patient that acknowledges the role of each in the total healthcare program.

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PATIENT HEALTH QUESTIONNAIRE-9 (PHQ-9)

WebFeeling down, depressed, or hopeless. 3. Trouble falling or staying asleep, or sleeping too much. 4. Feeling tired or having little energy. 5. Poor appetite or overeating. 6. Feeling bad about yourself — or that you are a failure or …

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IN CASE OF EMERGENCY Phone # Alternate Phone # NOTICE …

WebThe above information is true to the best of my knowledge. I authorize my insurance benefits be paid directly to Affiliates of Family Medicine. I understand that I am financially responsible for any balance. I also authorize Affiliates of Family Medicine to release any information required to process my claims. Patient/Guardian Signature Date.

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Affiliates of Family Medicine NOTICE OF PRIVACY PRACTICES …

WebHIPAA Policies and Procedures Manual Page 2 of 7 ©2013, Texas Medical Association and Jackson Walker LLP, All Rights Reserved C. For Health Care Operations.

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MEDICAL RECORDS RELEASE FORM

WebOFFICE USE ONLY FAXED: _____ MAILED: _____ PT PICK UP: _____ INITIALS: _____ MEDICAL RECORDS RELEASE FORM By signing this form, I agree and acknowledge the following:

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REGISTRATION FORM

Web• I voluntarily request Dr. _____ as my physician, and such associates, technical assistants and other health care providers as they may deem necessary, to render primary healthcare services.

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2 Assignment of Benefits Form

WebAssignment of Benefits: I hereby assign all medical and surgical benefits, to include major medical benefits which I am entitled. I hereby authorize and direct my insurance carrier(s), including Medicare, private insurance, and any other health/medical plan, to issue payment directly to Affiliates of Family Medicine for medical services

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MEDICAL RECORDS RELEASE FORM

WebOFFICE USE ONLY FAXED: _____ MAILED: _____ PT PICK UP: _____ INITIALS: _____ MEDICAL RECORDS RELEASE FORM By signing this form, I agree and acknowledge the following:

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503 Medical Center Blvd., Suite 100 28517 Spring Trails Ridge, …

Webunderstand that at any time I can refuse to see a physician assistant or nurse practitioner and request to see a physician. Patient Name: Date. Signature: Witness: 503 Medical Center Blvd., Suite 100 Conroe, Texas 77304 Phone 936-788-1060 Fax 936-788-2844. 28517 Spring Trails Ridge, Suite 100 Spring, Texas 77386 Phone 281-362-5436 Fax 281 …

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4 Medical Records Release Form

WebOFFICE USE ONLY FAXED: _____ MAILED: _____ PT PICK UP: _____ INITIALS: _____ MEDICAL RECORDS RELEASE FORM By signing this form, I agree and acknowledge the following:

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