We realize that our patients’ time is valuable and we make every effort to see patients at their scheduled time. However, occasionally, our office falls behind schedule and we ask for your understanding. We also ask that patients provide as much advanced notice as possible when running late for an appointment or when needing to cancel. With this advanced notice, the time can be scheduled for another patient. Patients who fail to give at least 24 hours advanced notice of cancellation will be charged for their appointment.
What to Bring to Your Appointment
- Your current health insurance card
- Driver’s license or picture I.D.
- Physician referral forms if required by insurance
- A list of current prescriptions or over-the-counter medications you are taking, including dose and frequency.
- Pertinent medical records including films and/or test results
- Patient Forms
If you are a new patient or have not been seen in the last twelve months, please click on the appropriate forms below and print. Bring the completed forms to your appointment.
- Professional Services Agreement (PDF)
- New Patient Medical History Form (PDF)
- Data Intake Form (PDF)
- Telehealth Consent Form (PDF)
- Release of Confidential Information Form (PDF)
- Patient Rights and Responsibilities (PDF)
- Notice of Privacy Practices (PDF)
Insurance and Payment Information
Hauser Clinic and Associates is a provider for most Medicare and Tricare plans. We do not accept any other insurance plans and expect payment upon receiving services. We will assist patients that do have insurance by providing them an insurance claim form they can send to their insurance carrier for reimbursement. If you have any questions, please contact us at 713.669.0303.