(407) 351-9696

New Patient Forms

Insurance:

We accept nearly all major insurance plans including:

  • Cigna

  • United Healthcare

  • Ambetter
  • 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! Save time when visiting the office by printing and completing the New Patient forms below. Please make sure to complete both the New Patient Registration and Health History forms.

You can also download a copy of our Office Policies: