Welcome to Lake Village Clinic.
PART OF PROVIDING SUPERIOR HEALTH CARE IS MAKING IT EASY FOR YOU TO RECEIVE IT.
PATIENT UPDATE AND PRIVACY FORM
NEW PATIENT FORM
SLIDING FEE APPLICATION
New Patient Guide
Are you a new Patient?
If so, you can download the forms on this page, fill them out and bring them with you at your appointment. These forms provide us with patient information and authorizations for your file. This allows us to speed up the paperwork process and serve you better.
On your first visit, it is very important that you bring:
1. All Health Insurance Cards including Medicare, Medicaid and Social Security Card.
2. All medicines that you are currently taking.
3. Picture of yourself we can keep for medical record.
Insurance coverage accepted from the following:
*A copy of valid insurance card is needed