Thank you for considering Hass Family Medicine. PLEASE REVIEW the following before submitting your contact information.

  1. Age: As not all our clinicians in the call group are able to cover patients under 18 years of age, at present, we can only accept patients who are age 18 years or older.
  2. All new applications received will be placed on a waiting list once all three (3) new patient forms are completed. IF ALL 3 forms are not complete correctly, that application will not be placed on the list.
  3. Specialist care: We try our best to use local specialists as travel off Cape can be difficult and inconvenient. As part of the Tufts Medicine Integrated Network, we refer to Tufts Medical Center Boston for all specialist care not rendered on Cape. We can submit any request for special consideration for outside options, however, approval for services outside the Tufts network cannot be guaranteed.
  4. Insurances Accepted: Aetna Commercial (Not Aetna Medicare plans), Allways/Mass General Brigham, Blue Benefit, Blue Cross Blue Shield, Cigna, GIC/Unicare, Harvard Pilgrim, Health Plans Inc, Tufts Commercial (Non-Mass Health), Tufts Medicare Preferred, Tufts Senior Plans, Tufts Navigator, Tufts CCHC Plan, UMR, United Healthcare (Not their Medicare Plans).  As of March 31st we are closed to Medicare.

If you want to join the practice, PLEASE PRINT OUT THE THREE (3) FORMS AND MAIL IN. Only those applications that are completed will be accepted. If your forms are not completed correctly, you will not be processed. We will do our best to accommodate as many patients as we can safely.

Note: The medical release form MUST HAVE THE PREVIOUS PCP NAME PHONE and FAX NUMBER. If this is not completed properly, the application will not be processed. We do not have the staff to track patients down or search the web for information.

New Patient Forms

In preparation for your first visit with us, please download, review, print out and sign three (3) forms below. You will not be seen without all signed forms.