Prepare for a Clinic Visit

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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)

  1. Identification (valid Louisiana driver's license or Louisiana photo ID card)
  2. Social Security card
  3. Insurance card, Medical Cards, Medicaid Card (if Medicaid, you MUST have a referral from assigned provider)
  4. 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:

  1. 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.