New Patient Forms & Instructions
For your convenience we have provided a full set of forms that may need to be completed upon your first visit to our offices. Just download the required forms, print and complete in the comfort of your own home prior to your visit.
If you have any questions concerning which forms are needed or what to fill in, please contact our offices. We will be happy to guide you through the process.
Patient Forms (English) - Dr. Burk Patient Forms (Spanish) - Dr. Burk Patient Forms - Dr. Gilmore Patient Forms (Spanish) - Dr. Gilmore
Medical Records Release
Insurance Plans Accepted
- AARP
- AETNA
- AETNA MEDICARE
- BCBS
- BEECHSTREET BOON
- CARE IMPROVEMENT
- CHAPMAN
- CIGNA
- COVENTRY
- EYEMED
- FIRST CHOICE
- FIRST HEALTH
- GEHA
- GREAT WEST
- HEALTHSMART
- HEALTHSPRINGS
- HORIZONS
- HUMANA PPO/HMO
- MULTIPLAN
- MOLINA
- MOLINA MEDICARE
- MAILHANDLERS
- MEDICAID
- MEDICARE
- SECURE
- SUPERIOR
- SUPERIOR ADVANTAGE
- TRICARE
- TX PLUS
- UMR
- UNITED HEALTHCARE
- VISION
- VSP
- WELLCARE