Baylor Scott & White Hillcrest Marketplace Clinic

If you have questions about your account or billing information, contact your Hillcrest clinic directly or contact the Hillcrest Billing Department. 

Phone: 877.267.1085

HFHC Billing Department
PO Box 5308
Waco, Texas 76708

We accept most major insurance plans providing healthcare coverage.

To determine exact insurance coverage, please call the phone number listed on your insurance identification card. If you have any questions about your insurance coverage itself, you may also call the Hillcrest Billing Department at 877.267.1085.

Authorization for Release of Medical Information

• Authorization for release of Medical Information (English)
• Autorización para la diseminación de la información médica

Male Patient Intake Forms

• Patient History for Men
• Patient Record Information
• Consent for Medical Care - Assignment of Benefits
• Formulary Benefits Consent Form
• Notice of Privacy Practices
• Patient Agreement

Female Patient Intake Forms

• Patient History for Female
• Patient Record Information
• Consent for Medical Care - Assignment of Benefits
• Formulary Benefits Consent Form
• Notice of Privacy Practices
• Patient Agreement

Child Patient Intake Forms

• Patient History (Children Under 2)
• Patient History (Children 2-10)
• Patient History (Children 11-17)
• Auth for Medical Treatment of Minors
• Patient Record Information
• Consent for Medical Care - Assignment of Benefits
• Formulary Benefits Consent Form
• Notice of Privacy Practices
• Patient Agreement
• ImmTrac Consent form

General Clinic Forms

• Patient Portal Authorization
• Living Will form
• Power of Attorney
• Health Risk Assessment

Intake Forms - Español

• FORMULARIO DE ANTECEDENTES PARA MUJERES
• FORMULARIO DE ANTECEDENTES PARA HOMBRES
• INFORMACIÓN DE REGISTRO DEL PACIENTE
• CONSENTIMIENTO DE ATENCIÓN MÉDICA/CESIÓN DE BENEFICIOS
• FORMULARIO DE CONSENTIMIENTO RESPECTO DE LOS DATOS DE BENEFICIOS FARMACÉUTICOS
• AVISO DE PRIVACIDAD
• ACUERDO DEL PACIENTE