What to bring with you to your appointment:
- Picture ID
- All insurance information
- Required Referral letter from your Primary Care Physician (community care referral)
- Any required co-payments/deposits (University Health Conway accepts VISA and MasterCard)
- Current proof of income
- Your medications - prescription bottles and over the counter medications
Items to note before your appointment:
- You must be registered for each clinic visit or before having a test
- Please allow yourself time to go through Registration before your appointment
- Please leave valuables at home.
Payment of Services:
- If you are uninsured and unable to provide proof of Louisiana Residency at the time of registration, you may be required to pay a minimum $100.00 non-Louisiana Resident fee at each clinic visit
- If your insurance plan does not list University Health Conway as an in-network provider, you may be responsible for up to 100% of the hospital and physician bills.
To determine if you qualify for free care, you must bring the following documentation to your appointment:
If single: (divorced, widowed, never married)
- Identification (valid Louisiana driver's license or Louisiana photo ID card)
- Social Security card
- Insurance card, Medical Cards, Medicaid Card (if Medicaid, you MUST have a referral from assigned provider)
- Proof of income - Check stub (if self employed, form 1040 plus schedule C, D, E, & F). If no income - you will need to have a notarized form (please call 318.330.7180 to request this form)
If married or separated:
- You must bring all of the items listed above for yourself AND your spouse. As long as you are legally married, spouse's information is required even if separated.