Dan Baker, MD - Board Certified in  Family Medicine and Sleep Medicine
Call for more info: 512-310-8883
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  • Humana
  • Aetna
  • Blue Cross Blue Shield
  • CIGNA
  • United Health Care
Insurance
For specific information about your insurance plan, please call your insurance provider. If you have billing questions call our billing department.

If you do not see your insurance provider listed below, please call for full list of insurance providers we accept. If you are not covered by one of these providers we will ask you to pay for your services at the time of service but will be happy to help you file with your insurance.
Demographic forms and Policy Sheets
CONFIDENTIALITY FORMS
Form for release of information,
Forms
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Print and complete these forms to speed up your visit.
MEDICAL RECORDS REQUEST FORM
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  • Great West
  • Texas True Choice
  • Private Health Care Systems
  • Beech Street
  • First Health
ADULT HEALTH HISTORY FORM
Ages 16 and Up
Ages 5 through 15
PEDIATRIC HEALTH HISTORY FORM
NEW PATIENT PACKET
(CLICK HERE)
(CLICK HERE)
(CLICK HERE)
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(CLICK HERE)
PARENTAL CONSENT FOR TREATMENT OF MINOR PATIENT