Request an Appointment

Complete and submit the form below to request an appointment. Please allow one business day for a response. An appointment scheduler will contact you with the best available appointment, based on the information you provide. Requests for appointments are handled through a secure server. You can also call 254-298-2500 to speak with an appointment scheduler directly. If you do not wish to request an appointment our walk-in clinic, First Med, is available first come first serve.

Items marked with are required

4.     Are you a: Current PatientNew Patient
5. Please provide your contact information:
Patient
First Name	M.I.	Last Name
Date of Birth
Parent/Guardian
First Name	Last Name
Do you prefer to be contacted by
EmailTelephone
E-Mail Address
Main Phone Number	Secondary Phone Number
Best Time to Call

6. Please provide convenient dates and times for your appointment, ranked in order of preference, Our clinics are open monday thru friday
Date Requested	Time
Date Requested	Time
Date Requested	Time

Please tell us the name of your Primary Care Doctor:
First Name	Last Name
Please tell us the name of the doctor who referred you (if applicable)?
First Name	Last Name
Please tell us the reason for this appointment request: Reason for appointment: Adult Physical Child Physical Clinical Tests Follow-Up Visit Sick Visit Other
If you selected "Other" please specify:
Please tell us your insurance company: Health Insurance: Accountable Health Plan (Interplan) Aetna Health Insurance Beech Street Blue Cross Blue Shield Doc First First Care Great-West Healthcare HealthSmart Preferred Care Humana Humana Military TRICARE Medcorp SW PPO Next Private HealthCare Systems (PHCS) Network Scott & White Senior Care Seton Health Texas True Choice UniCare United Healthcare USA Health Will pay at time of service Other
If you selected "Other" please specify:
Additional Comments