(407) 351-9696

New Patient Forms

Insurance:

We accept nearly all major insurance plans including:

  • Cigna
  • United Healthcare
  • Ambetter
  • Oscar Health
  • Aetna
  • Humana
  • Blue Cross Blue Shield**

For the most up-to-date information on our accepted private health insurance plans, contact our office directly at 407-351-9696.

**We are not in-network with some of the BCBS plans offered on the healthcare marketplace including Blue Select**

New Patient Forms

Thank you for choosing Harris Internal Medicine! Please complete the new patient forms below prior to your scheduled appointment. Make sure to complete both the New Patient Registration Form and the Health History Form. Email the completed forms to info@harrisinternalmedicine.com.

You can also download a copy of our Office Policies: