Patient Forms Forms to Complete About DilationPlease download, fill out, and print our four patient forms by clicking on the links below. Please bring these forms with you to your appointment.Assignment of BenefitsDeclaration of BenefitsDemographicsHIPAAInsurance InformationWe accept most major PPO insurances:MedicareMedicaidCulinaryAetnaCignaAnthemBlue Cross Blue ShieldTeacher’s Health TrustUniversalSt. Mary’sGalaxyGreat WestHumana Choice Care (PPO Only)Prime HealthUSA HealthIf you have any question as to whether we take your insurance, please do not hesitate to call us at 702-816-2525 as this list is not all-inclusive