Patient Forms, Map and Directions to Gonzales Office
Your first visit to The Vaz Clinic, PA establishes a vital foundation for our relationship with you. During your first visit, we make sure to obtain important background information about your medical history and give you time to get to know your doctor.
To understand what to expect for your first visit to our practice, please read through this page. You'll find all the practical information you need, such as a map and directions to our office, practice hours, payment policies and more.
New Patient Information
Whether you are new to the area or don’t have a primary care provider look no further. The Vaz Clinic, P.A. has highly qualified Physicians and Nurse Practitioners available to help. If you have questions, please contact our office representatives for guidance.
Things to bring to your first appointment:
1. Your current Insurance Card and valid Photo ID. We follow very strict privacy guidelines in order to protect our patient's identity and prevent fraud. We require both of these at the time of your appointment.
2. A list of providers who you receive care from. A list of your medications and their dosages, both over the counter and prescribed.
3. A list of your previous surgeries or conditions that you have received treatment for.
4. Your vaccination record.
5. Completed New Patient Registration Form available on this website for your convenience
6. Completed TVC Financial Policy Form available on this website for your convenience
7. Completed HIPPA Authorization Form available on this website for your convenience
Please arrive 15 minutes prior to your scheduled appointment time to allow us to verify your information and fill out any necessary paperwork. Part of providing top notch care is knowing the patient; we will ask you about your family history and other vital background information during your first appointment.
** If you have HMO insurance and you have another provider's name listed as your PCP, please call your insurance company to have this changed before coming in for your appointment. Unfortunately, the insurance companies do not allow us to make this change on your behalf.
** If you are receiving care due to an injury covered by a Workman's Compensation Insurance, please note, you must contact your case worker before your appointment and receive authorization to see us. We will need your claim number, authorization number, case worker's contact information and the name, address and phone number of the Insurance Carrier.
Our practice is working together to realize a shared vision of excellence in medicine.
- Listening to those we are privileged to serve.
- Earn the trust and respect of patients, profession, and community.
- Exceed your expectations.
- Ensure a creative, challenging and compassionate professional environment.
- Strive for continuous improvement at all levels.
Please print and fill out these forms and bring them with you so we can expedite your first visit:
- Registration Form s English
- Registration Forms Espanol
- TVC Financial Policy
- HIPPA Authorization Form
NOTE: For the Patient Survey please download and either mail or drop it in the survey box at the clinic.
In order to view or print these forms you will need Adobe Acrobat Reader installed. Click here to download it.
What To Expect
Being well-prepared for your appointment will ensure that the doctor has all necessary information to provide you the best possible care. It also will help relieve any unnecessary anxiety you may be feeling. Educate yourself on your symptoms by reviewing our Patient Education section. Also, take some time to review our staff page and familiarize yourself with the doctors. We look forward to your first visit.