OFFICE HOURS: 8:30AM - 5:00PM PATIENT PORTAL LOGIN REQUEST AN APPOINTMENT Insurance & Forms Insurance We participate in a variety of insurance plans and financing options for our patients. We will file your bill with your insurance company when provided a copy of your insurance card. If we do not participate with your insurance plan, you may be reimbursed at a reduced rate if you submit a bill to your insurance company. CareCredit: With CareCredit healthcare, financing is made easy. Whether you use your healthcare credit card for your deductible or to pay for treatments and procedures not covered by insurance, CareCredit helps make the health, wellness, beauty treatments, and procedures that you want done, possible. Insurances we Participate with: Aetna, Aetna Medicare Avmed Blue Cross Blue Shield – All Plans CIGNA Coventry National Humana PPO/HMO, Medicare Medicare, Florida Health Care Medicare Multiplan/PHCS Tricare, Tricare Prime, Tricare Select United Health Care, UHC AARP Medicare Complete Plan Medicaid Plans we Participate with: Medicaid - Primary Only Sunshine United Health Care/ UHC Healthykids Wellcare/Staywell/Staywell Kids Florida Aetna Better Health Florida Ambetter Exchange Florida Molina Marketplace Florida Health Care Plans: Flagler Hospital (FHCP) only Forms Below is a list of documents pertaining to our practice. If you would like to fill out your initial paperwork at home, please download the following forms and bring them to the office prior to your visit. We update the patient registration form annually. Fill out the health history form only if you are new to our practice. New Patient – GYN Health History & Registration | Click to Download PDF Established Patient – GYN Health History & Registration | Click to Download PDF OB Health History & Registration | Click to Download PDF Biote Patient Assessment | Click to Download PDF Request an Appointment Please fill out the form and be sure to include your preferred date and time. Name Email Address Phone Number Date Time HH MM AM PM St. Augustine (904) 819-1500 Suite 3002 in Flagler Hospital 300 Health Park Blvd St. Augustine, FL 32086 Palm Coast (904) 819-1500 5 Boulder Rock Drive Palm Coast, FL 32137 Palatka (904) 819-1500 700 Zeagler Drive, Suite 3 Palatka, FL 32177 World Golf Village (904) 819-1500 Village at Murabella 70 Turin Terrace, Suite 200 St. Augustine, FL 32092 © Copyright 2020 OBGYN Associates