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What You Need, Where You Are

Patients
Chambers Health

Patients

Through a team model of care, we work together at Chambers Health, across all our operations, to insure that we listen and learn your needs and concerns. Delivering the best possible outcome for you and your loved ones is what drives and motivates us; being the best we can for you and yours. Our patients and customers are the only reason we exist.

We believe you have a right to receive considerate, respectful care, based on your social, physical and spiritual needs, no matter your ethnicity, origin or financial situation. We will work to insure that you receive accurate, timely and easily understood information about our programs and services, that you are aware of all your treatment options and alternatives, and, to participate in decisions about your care. We will provide an environment that insures you may speak in confidence with any member of our staff, and that your personal healthcare information will be protected.

We accept most major medical insurance, and will be happy to bill your carrier for you. To support this process, we ask that you provide our staff with current insurance information and promptly fulfill any financial obligations. We also have programs in place to provide services to the under/uninsured individuals and families in our community, and staff to assist with those applications and processes.

We understand, recognize and will always respect that it is you who allows us the privilege to be of service.

Patient Forms

We offer you, our patient, the ability to download and print any of the following forms.  These are the same forms you would fill out once arriving at our office.  Please feel free to print these forms and complete them before seeing one of our providers, if you are a new patient.  By completing these forms before your first visit, it will save us time in setting up your patient file and reduce the amount of time you spend in our waiting area. 

Clinic forms

Hospital forms

Other forms

When faxing the forms, please send 24 hours in advance if possible with a copy of your photo ID and front and back of your insurance card(s).

If you have any questions, please do not hesitate to call us at the numbers shown below.

You may bring the forms with you, or may fax them to: 

 Bayside Clinic, phone # 409-267-4126, fax # 409-267-4120

 Bayside Community Hospital, phone # 409-267-3143, fax #409-267-3380

 The Wellness Center at Bayside, phone # 409-267-3700, fax #409-267-3710

 West Chambers Medical Center, phone #281-576-0670, fax #281-576-0673

 

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