For Patients

Patient Information & Forms

Patient Information & Forms

Thank you for selecting The Centers for Kidney Care for your nephrology needs. We have built a practice that is founded on the care and support of our patients. Our physicians have an assigned team to assist you during your visit with our clinic. The physician’s teams consist of Advanced Practitioners, Clinical Support and Scheduling team members. The entire team at The Centers for Kidney Care will strive to make your visit with us informative and as pleasant as possible. Below is information about scheduling and forms that you will need complete prior to your visit with us. We truly appreciate the confidence you have placed in us and we look forward to sharing in your healthcare needs.

The Acumen nEHR® Patient Portal is an online application that allows our patients or authorized representatives of our patient to log in and access upcoming appointments and clinical information, such as medications, allergies, problems, lab results, vital signs, and message our providers or their team through a secure messaging system. You can access the patient portal through this link:

New Patients

All new patient appointments are scheduled at the referral of your primary care physician. We do not accept self-referrals.

On the day of your appointment, please plan to arrive 30 minutes prior to your scheduled appointment time. This allows us time to verify all new patient paperwork is complete and for you to see the provider at your scheduled time. You may print this paperwork from the links below.

The following forms need to be completed:

  • New Patient Letter
  • Patient Information Form
  • Patient Encounter Form
  • Patient Medical History Form
  • Patient Authorization
  • Authorization for Release of PHI
  • Patient Financial Policy
  • Patient Acknowledgement of Privacy Practices
  • Notice of Privacy Practices



Please bring to your first visit:

  • Insurance Card
  • Driver’s License or Photo Identification
  • Complete Forms (unless submitted online)
  • All current medications you are taking. Please bring medications in the
    original bottle, Do Not Bring a list.
  • We do not require any fasting labs.

If you still have questions about scheduling a new patient appointment, please email our office at

Request an Appointment

To request a follow-up appointment, please call our office and speak with your physician’s scheduler.

When calling to schedule your appointment, please be sure to have your current insurance information available. Our office will verify your insurance before scheduling your appointment. If there is a problem with your insurance, we will contact you prior to your appointment. If your insurance requires a referral from your primary care physician, we will let you know. We participate in a number of
insurance programs; however, it is your responsibility to verify that the physician you are seeing is in network.

Please bring the following to all follow-up appointments:

  • Insurance Cards
  • Patient Encounter Form (English | Spanish)
  • All current medications you are taking. Please bring medications in the original bottle.
  • Blood Pressure Log, if requested by your provider.
  • We do not require any fasting labs.

Cancel an Appointment

If you need to cancel a scheduled appointment, please notify us at least 48 hours in advance.

Office Hours

  • Tyler Office: Monday – Thursday, 7:00 AM – 5:00 PM and Friday, 7:00 AM – 1:00 PM
  • Paris Office: Monday – Thursday, 8:00 AM – 5:00 PM and Friday, 8:00 AM – 12:00 PM

Telephone Calls

All phone messages left prior to 3:30 PM will be returned the same day. Any messages left after 3:30 PM will be returned on the following business day.

AFTER HOUR EMERGENCIES: One of our providers is always available for after hour emergencies. Please call our office number (903) 595-5486 and you will be directed to our answering service. Provide them with your name, phone number and the nature of your problem and the provider on call will be notified and return your call.

If you feel the situation represents a life-threatening emergency, proceed IMMEDIATELY to the nearest hospital emergency room.

Lab Testing

Our providers request that you come to the office one week before your scheduled appointment to have laboratory testing so that the reports are available to discuss with you at the time of your appointment. This appointment will be scheduled at the same time the follow-up appointment is scheduled.

We encourage you to register on our patient portal to receive lab results more quickly.

Prescription Refills

If you need a prescription refilled, please call your pharmacy and have them send a request to our office through our electronic medical records system.


New Patient Forms:





Other Patient Forms: