Patient Resources

Forms For Newly Enrolled Patients

Please download and sign the following forms prior to your first visit.

• Notice of Privacy Practices

• Patient Agreement

• Authorization for Release of Confidential Information

• HIPAA Approved Contacts

REFERRAL FOR DENTAL AND VISION INSURANCE

I have partnered with Spirit Dental and Vision to offer you low cost dental and vision insurance.  You can purchase these individually or bundle them for greater savings. Click on the links below to learn more.

• Spirit Dental Brochure

• Vision Insurance Brochure 

For more information on these plans and to enroll, contact our Spirit Dental and Vision Agent Sean Pfeiffer at 214-718-8806 spfeiffer@referenceinsurance.com

REFERRAL FOR CATASTROPHIC CARE

We have partnered with Sedera Health Share to offer you exclusive, low premium catastrophic care.  What is catastrophic care? Catastrophic coverage helps with those hefty medical bills from hospitals, ER visits, and even surgery.

Since patients are being seen and cared for by quality health professionals at Gem MD, Sedera has agreed to offer catastrophic coverage to patients at a highly discounted rate and are available exclusively to those enrolled in the Direct Primary Care clinic. Click to see the Sedera Health Brochure to learn more about this health share.

In summary, patients enrolled with Gem MD have three options:

1.  Don’t enroll in the health share and keep the catastrophic care that you already have. 

2.  Enroll in Sedera Health Share and get great catastrophic coverage.

3.  Choose to go without catastrophic coverage.

This great deal is offered exclusively to patents who are already enrolled in Rockwall’s Gem MD, so get enrolled today!

For details about Sedera or to get help with enrollment, please contact the representative Sean Pfeiffer

214-718-8806 spfeiffer@referenceinsurance.com

Scan the QR code or use this link for pricing and to enroll in Sedera online https://www.1enrollment.com/index.cfm?id=797069