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Before your Visit  
Get a head start.
Shorten your office visit by filling out the necessary forms ahead of time. Please fill out the forms below and either fax them or mail them to us.
(512) 863-4248 (fax)
Chisholm Trail Pediatrics
600 High Tech Dr.
Georgetown, Texas 78626

The following forms are in Adobe Acrobat format, and you must have the browser plug in installed to view these forms. If you do not already have the plug in installed, please download the Adobe plug in here.
Patient Information Sheet
Medical History
Medical Services and Consent Form
Privacy and Confidentiality
Assignment of Benefits-Financial Agreement
Authorization for Release of Medical Information
View all of the forms together
We are affiliated with many insurance companies. Please contact your insurance company to see if we are in-network. A few of the major insurance companies we accept are as follows:

Aetna
Beech Street
Benefit Planners
BlueCross BlueShield
Cigna
CCN
Great West Healthcare
Healthsmart Preferred Care
Humana
Mega Life
PHCS
Scott & White
Seton CHIP
Seton Health Plan
Texas True Choice
TriCare
UniCare
United Healthcare
 
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