Patient resource center

Click Here to Access Patient Portal 

We are currently unable to screen new patients!

Only Telehealth Available at TOMAGWA until 3/30

Please call the numbers below for any assistance:

Patient Access: (409) 234 - 4869

Medical: (409) 234 - 1403

How to become a patient at TOMAGWA

Initial requirements for becoming a patient at TOMAGWA are that you must:

            1) Live in our service area,
                  (Zipcodes:  77068, 77069, 77070, 77316, 77354, 77355,                                          77362, 77363, 77375, 77377, 77379, 77388, 77429, 77447,

                   77484, &view list by county or city/township by clicking here),

           2) Have a household income (only includes dependents) of  200%

                    or less of poverty level (click here for federal income examples),       

            3) Complete forms below and provide requested information, and

           4) Complete a screening eligibility visit.

**New patient visits are $40 for the patient contributions for other services click here**

Individuals interested in becoming a patient at TOMAGWA must bring the below completed documents to a free screening.

***Patients are screened on a first come first serve basis so come as early as possible.**

  • Tomball Screenings: Tuesday & Thursday at 7:30am
  • Magnolia Screenings: Monday & Wednesday at 2pm

New patient forms:

What you need to bring - English | Lo que necesita traer- Español

Eligibility Application - English |Solicitud de Elegibilidad-Español

HIPPA Disclosure - English | Divulgacion de HIPPA -Español

Statement of Support - English | Declaracion de Apoyo - Español

Wage Verification - English | Verificacion de Salario  - Español

Medical History - English | Historial Medico - Español

Click Here for New Patient Flyer

Click Here for Immunization Clinic Flyer