Patient Information


Health History Questionnaire

Patient Update and Privacy Form

Financial Policy

Release to Obtain Medical Records

New Male Patient Packet

New Female Patient Packet

Apply For Credit

Patient Portal.

  • Request an appointment
  • Request a medication refill
  • Send a message to your provider's office
  • Receive medical information from your provider's office
All from one convenient place.

New patients should arrive 20 minutes before their scheduled appointment. The forms on this page should be printed and filled out and brought with you to the first appointment….

Information about Appointments in Bridge City

Office visits are by appointment only to help us keep waiting times to a minimum. It is our goal to follow appointment schedules as closely as possible, however, if an emergency arises that would cause a delay, we will attempt to keep you informed. If you need to cancel an appointment, please call as far ahead of time as possible, preferably at least 24 hours. There is a no-show fee for missed appointments if you do not contact us to let us know you won’t be coming.

Insurance/Billing Information for Bridge City Clients

We can submit primary and one supplemental insurance claim for you, filed at no charge (subject to your having given us current insurance information before services are provided). Copayments, deductibles, and out of pocket transactions must be paid at the time of service. Approximately 45 days after we submit a claim to your insurance company, any unpaid charges will appear in the "patient's responsibility" space on your statement and payment must be received before the next billing date. The financial responsibility for service provided to you remains yours. We request current insurance cards, and if the insurance information is inaccurate, the balance is the patient's responsibility. If you are unable to pay your charges when they are due, please contact our Patient Accounts Manager to discuss a payment plan. Payment may be made by cash, check, ATM card, VISA, MasterCard or Discover Card. You may qualify for a payment arrangement and/or auto draft for balance payments. You may make your payment online or sign up for e-statements if you prefer.

Register for Golden Triangle’s Patient Portal

This safe and secure website allows you to conveniently communicate with your provider at any time, day or night. Here, you can request an appointment or medication refill, send a message to your doctor, and receive medical information from your provider's office, all from one convenient place. Our goal is to provide accessible health care, and the patient portal is one of the ways we can provide an improved patient experience.