For Our Patients

If you’re a new MIMA patient, we want to make getting started as easy as possible. If you’re an existing patient, we know that other matters may require your signature such a release of records or personal directives. Below you’ll find a collection of forms that you can print out that will save you time when you get to the office.

Patient & Legal Forms
To download the forms, click on them below:

• Authorization For Services Form
• Patient Registration Form
• Living Will
• Medical Information Release
• Medical Information Release for Minors
• Florida Designation of Health Care Surrogate

Insurance
MIMA accepts most major insurance plans. The following is a list of insurance plans currently accepted by MIMA providers:

Accountable Health Plans	AETNA
BCBS	CCN
Cigna	Coventry/Southcare
Evolutions	First Health
Great West	Health First Health Plans
Medicaid	Medicare
NPPN	One Health Plan
PHCS	Plan Vista
Railroad Medicare	Tricare Standard
United Healthcare

*This list is not all-inclusive and is subject to change without notice*

Billing Questions
For any billing questions, contact the MIMA Billing Dept by clicking here and filling out the online form

MIMA Locations
Visit the MIMA Locations page for a list of our locations, physicians at each location and a map - click here

Education
To see what exciting classes and seminars MIMA has to offer, visit the MIMA Education page.