What You Will Need (Patient Checklist)

Before Your Visit

To help move the initial patient process along, it is helpful to fill out the New Patient Packet before your first appointment. The packet includes:

• Patient Demographic Information
• Insurance Policy Holder Information
• Provisions for Care Signature Form for Assignment of Benefits/Authorization to Release Medical Information, Notice of Privacy Practices, Consent to Treatment, and Financial Agreement
• Patient Portal: My Care Plus registration form (optional)
• Medical History
• Current Medicines and Symptoms Form
• Notice of Privacy Practices
• Map of Area surrounding Missouri Cancer Associates

We also encourage you to bring:

• A friend or relative
• Health insurance cards, Driver’s License or other government issued photo ID
• A list of questions to ask your physician and nurses
• Items to help pass the time between appointments, such as a book and/or mobile devices (Free Wi-Fi)
• A list of your current physicians with phone numbers and addresses
• Release of Information Form