Patient Information

Frisco Spine

Patient Forms

Below are some of our forms. If you are unable to print at home we are happy for you to complete them at the office. Please arrive 15 minutes before your scheduled appointment to allow time to process forms. If you are a new patient to our practice please complete the New Patient Form and bring the form to the appointment. If you are a returning patient and your name, insurance, address or phone has changed since your last visit to our office, please complete the New Patient Form.

New Patient Forms

     
New Patient Form      
       

Additional Forms

   

Notice of Privacy Practices

   

Acknowledgment of Privacy Practices

   

Authorization of Release

   

Follow-up Patient Questionnaire

  This form is completed by all returning patients.

Surgery Information

  This is the packet we provide to our patients when surgery is scheduled.
       
       
       

Insurance Information

Everyone deserves to enjoy a life without back pain, which is why Frisco Spine proudly accepts a number of different insurance plans. We are constantly expanding our list of accepted providers so if yours is not listed here, please call us to double-check for coverage.

Insurance affiliations include: 

  • Accountable PPO
  • Aetna HMO / PPO
  • Aetna Medicare
  • Alliance WC
  • Amerigroup Medicare/Medicaid
  • Averde Health PPO
  • Blue Cross / Blue Shield PPO / POS / HMO
  • Beechstreet / PPOnext PPO
  • Bravo Healthcare Medical
  • Care Improvement Plus
  • Care N Care
  • Cigna HMO / PPO/OAP/OAPC
  • Cigna Worker's Comp
  • Choicecare PPO
  • Choicecare Medicare
  • Choicecare Medicare Advantage
  • Coventry
  • FedMed PPO
  • First Health/Coventry Medicare Advantage PPO
  • First Health/Coventry PPO
  • First Health/Coventry Worker's Comp
  • Galaxy PPO
  • Great West PPO / POS / Open Access
  • HealthChoice OK
  • Health Smart - ACCEL
  • Health Smart -GEPO
  • Health Smart - POS
  • Health Smart - PPO
  • Healthspring Medicaid
  • Healthspring Medicare
  • Humana ChoiceCare PPO
  • Humana ChoiceCare Preferred
  • Humana ChoiceCare Medicare Advantage HMO
  • Humana ChoiceCare Medicare Advantage PFFS
  • Humana ChoiceCare Medicare Choice PPO
  • Independent Medical Systems PPO
  • Integrated Medical Systems PPO
  • Medcorp SW PPO
  • Medicaid
  • Medicare
  • Molina Medicare
  • Molina Medicaid
  • Oaklahoma Heathcare Authority
  • Parkland
  • PHS/Multiplan
  • Planvista (NPPN) PPO
  • Prime Health Services
  • Principal PPO
  • Scott and White Health Plan
  • Superior Health Advantage Medicare
  • Superior Health Medicaid
  • Stratose/Plan Vista/ NPPN
  • Texan Plus/ Today's Option/Universal American
  • Texas True Choice
  • Tricare
  • Tricare Prime
  • Unicare PPO
  • United Healthcare PPO / All Other / Secure Horizons
  • WellCare
  • WellMed
  • Wellspring

Hospital Information

Hospital affiliations include:

  • Baylor Hospital, Carrolton, TX
  • Baylor Hospital Grapevine, TX
  • Baylor Hospital, McKinney, TX
  • Baylor Hospital, Plano, TX
  • Baylor Heart Hospital
  • Baylor University Medical Center, Dallas, TX
  • Centennial Hospital, Frisco, TX
  • Children's Medical Center Plano, TX
  • Denton Regional Hospital, Denton, TX
  • Doctor's Hospital, Dallas, TX
  • Faith Surgical Center, The Colony, TX
  • Forest Park Hospital, Dallas, TX
  • Forest Park, Frisco, TX
  • Heritage Park Surgery Center, Sherman, TX
  • Lake Pointe Medical Center, Rowlett, TX
  • Medical Center of Lewisville, Lewisville, TX
  • Medical Center of McKinney, McKinney, TX
  • Medical Center of Plano, Plano, TX
  • Medical City of Dallas, Dallas, TX
  • Methodist Hospital of McKinney, McKinney, TX
  • Methodist Richardson, Richardson, TX
  • Methodist Surgery Hospital
  • Methodist Surgical Center Addison, Addison, TX
  • Paris Regional Medical Center, Paris, TX
  • Presbyterian Hospital, Flower Mound, TX
  • Presbyterian Hospital, Plano, TX
  • Preston Surgery Center, Dallas, TX
  • Star Medical Center, Plano, TX
  • Texas Health Resources, Flower Mound, TX
  • Texas Health Resources, Plano, TX
  • Texas Health Resources Rockwall, TX
  • Texoma Medical Center, Denison, TX
  • Victory Plano, Plano, TX

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