3102 Goodman Road, Horn Lake, MS 38637

Patient Information - Horn Lake Family Practice

New Patients

If you are a first-time patient coming to Horn Lake Family Practice, you may complete and print the following forms before coming to the clinic.

NOTE: If you prefer to receive and complete these at our office, please arrive 15-30 mins prior to your appointment.

>> Print and Complete these forms


CareQuality Opt-Out Form

This office has chosen to participate with CareQuality, a network that allows healthcare professionals to share patient information so that they may coordinate patient care. If you do not wish to have your information shared with CareQuality please fill out this form.


Payment Plans

We understand the hardships you may be going through, and we want to work with you to resolve your balance. Please review this form if you want to submit a payment plan.


Accepted Insurance

Below is a listing of health insurance plans accepted at Horn Lake Family Practice Clinic. Contact your insurance company for coverage and benefit verification.

These plans are subject to change at any time. If your plan is not listed below or to verify coverage, please contact our office at 662-342-6677.

• ADVANTRA FREEDOM
• AETNA
• CIGNA
• GHP
• Humana
• BCBS
• Mississippi Medicare
• MS Medicaid (only for children below 18)
• PITTMAN & ASSOCIATES, INC
• Tricare North Region
• United Healthcare


Patient Portal

Our Patient Portal facilitates better communication with your physician by providing convenient 24 x 7 access from the comfort and privacy of your own home or office.

Clinic Hours

Monday - Thursday: 8 am to 5 pm
Friday: 8 am to 12 pm
PH: 662-342-6676

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Clinic Hours

We are here to serve you
Monday - Thursday: 8 am to 5 pm
Friday: 8 am to 12 pm

New Patients

Download and complete the new patient forms and bring them with you during your scheduled appointment.

Pay Online

Make online payments easily through our secure payment gateway. Transactions are encrypted and fast!

3102 Goodman Road Horn Lake, MS 38637 | PH: 662-342-6676

Clinic Hours: Monday - Thursday from 8 am to 5 pm and Friday 8 am to 12 pm