Patient Information


Thank you for selecting our practice for your surgical healthcare needs.

Scheduling An Appointment:

To schedule an appointment, please call 713-756-8555 or 877-591-8715 (toll free).  You can also email an appointment request to receptionist@breasthealthhouston.com and one of our schedulers will get back with you promptly.

Please completely fill out the New Patient Forms below.  You may either mail the forms to us at 6800 West Loop South, Suite 520, Bellaire, Texas 77401 or fax the forms to our office at 713-756-8305 at least a week in advance so that we can get you into our computer system and verify insurance.  The originals should be brought to your scheduled appointment. 

Office Hours:

Our office hours are Monday through Friday from 9 a.m. to 5 p.m.

Preparing for Your Visit:

It’s best to wear comfortable clothing to your appointment. You will be asked to change into a gown for an examination.

Please bring the following to your appointment:

*  Films - Any films that have been taken for your condition. It is your responsibility to bring these to your first appointment so that you can be examined and the films reviewed at the same time. If you do not have the actual films, your appointment will need to be rescheduled.

*  Insurance card

*  Exact copay amount

*  Referral or authorization from your primary care physician to see a specialist.  If your insurance requires a referral or authorization from your primary care physician to see a specialist, then it is your responsibility to obtain that referral before you come to your office visit. If you do not have this referral, then our office will be required to reschedule your appointment. You should contact your insurance company directly to verify whether or not you require a referral.

*  Picture identification 

*  New patient registration forms (download below).  Please fill out completely and either fax in to our office at 713-756-8305 or mail to us at 6800 West Loop South, Suite 520, Bellaire, Texas 77401. The originals of your forms should be brought to your appointment.

Payment Policy:

Payment of all copays, estimated co-insurance and deductible amounts are required at your visit. Copays will be collected at check-in for your convenience.

Insurance Filings:

We are on the preferred provider list of many major insurance companies. However, since there are many divisions of insurance companies, it would be in your best interest to call your insurance provider to see if our practice is an in-network provider.

As a courtesy, we will file your insurance claims for you and will communicate with your insurance company to resolve payment issues. However, in some circumstances you may be required to communicate with your insurance carrier to resolve these issues. 

What to Do If Tests Are Necessary:

After being evaluated by a physician, it will be determined if tests are necessary. Depending upon medical findings and any symptoms that you are experiencing, some diagnostic tests may be ordered, including blood work. Most of the testing is done in our offices. At times, tests may be performed at an outside facility or local hospital.

Initial Prescription Fills and Refills:

If one of our doctors writes a prescription, you can take it to any pharmacy approved by your managed care plan or provider.

The best time to take care of prescription refills is during your office visit. At this time Dr. Bonefas or Dr. Birt can verify the medicines you are taking and make changes if necessary.

If you need your routine medications refilled between office visits, you should call your pharmacy with this request. The pharmacist will then contact us for a refill approval.

Filling out Forms for Diability, FMLA and others 

The office charges a fee for filling out medical forms such as those for FMLA and Disability. Please call the office to check on the cost and list of forms that require a fee. 

Patients Rights and Responsibilities / Privacy Policy:

We  value our patients rights and responsibilities as well as their privacy. To view our policies on these matters please click on the links below to view these documents.

Further Questions?  Click here to see our Frequently Asked Questions.




Downloadable Resources


New_Patient_Packet.pdf
Please completely fill out the New Patient Forms. You may either mail the forms to us at 6800 West Loop South, Suite 520, Bellaire, Texas 77401 or fax the forms to our office at 713-756-8305 at least a week in advance so that we can get you into our computer system and verify insurance. The originals should be brought to your scheduled appointment.


Medical_Records_Request[1].pdf
FORM: 5 - Medical Records Request Form





© 2017 Elizabeth Bonefas MD
6800 West Loop South, Suite 520 | Bellaire, TX 77401