Patient Forms & Insurance Accepted
Thank you for selecting Lakeview Dermatology for your dermatological care. To schedule an appointment, please call us at (817) 752-5256.
Once you have made your initial appointment, if your patient portal was enabled, you can log in there to enter your Medical History information, as well as update or correct any inaccurate registration information. If you are unable to access the portal, then alternatively, you can download and fill out the forms below and fax, email, or bring with you to your appointment. Whenever possible, we request you provide this information prior to your appointment, as it will save time and help your visit go more smoothly.
Please be sure to bring any prior biopsy reports, previous dermatologist notes, lab tests, or other records that could help your dermatologist provide you with the best care.
Please note: It may take a few minutes to load the forms if you are using a slow internet connection. If you are unable to view the forms, you may need to download Adobe Acrobat for free by clicking on the icon below.
At Lakeview Dermatology, we accept most major insurance plans. These include:
- Aetna Healthcare, HMO and PPO
- Blue Cross Blue Shield, PPO, Blue Essentials HMO, Blue Access Exchange
- Cigna Healthcare
- Choice Care & Humana Preferred, PPO
- Coventry National/First Health, PPO
- Galaxy Health, PPO, Medical Savings Card, and Medicare Supplement
- HealthSmart Preferred Care Inc., PPO, Accelerated Payment, Gatekeeper EPO, Health Payors
- Independent Medical Systems, PPO
- LoneStar Athletic Injury Network, PPO
- MultiPlan, PPO
- National Preferred Provider Network, PPO
- Nexcaliber (AAGI), PPO
- Oscar Health Insurance Company of Texas, EPO
- Private HealthCare System, PPO and Savility PPO
- Provider Select, PPO
- Ambetter from Superior Health, Exchange
- Texas Bluebonnet, PPO, EPO, and HMO
- Texas Health Resources (THR)/Aetna, EPO
- United Healthcare
- USA Managed Care Organization, PPO
Pending insurance plans include:
- Molina Healthcare
- Prime Health Services Inc.
- Scott & White Health Plan
- Three Rivers Provider Network, PPO
You may also contact your insurance company or call our office at (817) 752-5256 to find out if we accept your plan.