+1 (432) 400-3066 adaclinic3@gmail.com

New Patient Info

Welcome to Patient-Focused Care

We make it easy to save time before your visit with patient resources and printable forms.

In addition to our convenient online patient portal for appointments, questions, and bill payment, we also provide all the forms you’ll need here. Save time by printing our forms and completing prior to your office visit when needed.

What should I expect from the ADA Adult and Children Family Clinic?
Expect a truly patient-focused practice. As our patient, you gain access to a seamless system of integrated medical care, including in-house specialists in most areas of practice as well as ancillary services. Patients should bring their medication on their first visit.

What should I bring to my first visit to the ADA Adult and Children Family Clinic?
Please bring your photo identification and insurance cards with you to your initial visit. Your information will be scanned into our records system.

How does the ADA Adult and Children Family Clinic protect my medical records and information?
The ADA Family Clinic values your privacy. We act in accordance with guidelines outlined by the Health Insurance Portability and Accountability Act (HIPAA) of 1996 Privacy and Security Rules, and the Patient Safety and Quality Improvement Act of 2005 (PSQIA) Patient Safety Rule.

The ADA Adult and Children Family Clinic’s Notice of Privacy Practices
This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully.

Who Will Follow This Notice?
This notice describes the ADA Adult and Children Family Clinic regarding the use of your medical information and that of:

  • Any health care professional authorized to enter information into your medical record.
  • All practitioners of the ADA Adult and Children Family Clinic that you may visit
  • All employees, staff, and other personnel who may need access to your information.
  • All entities, sites, and locations of the ADA Adult and Children Family Clinic follow the terms of this notice. In addition, these entities, sites, and locations may share medical information with each other for treatment, payment, or health care services described in this notice.

Financial Policies 

We accept Visa, MasterCard, American Express, and Discover Card for your convenience. We deliver the finest care at the most reasonable cost to our patients, therefore, payment is due at the time service is rendered unless prior arrangements have been made. In most cases, your insurance plan requires you to make a co-payment at your visit.

We will ask you for your co-payment upon check-in. 

Please have your current insurance ID card available at each visit so we can avoid filing errors.


[wpdm_package id='263100']
[wpdm_package id='263101']