PATIENT FORMS
NEW PATIENT FORMS
NEW PATIENTS ONLY
Prior to your first appointment, please download, complete and bring with you the following PDF forms. These forms can be filled out on your computer by opening them in Adobe Reader (Please click the Adobe icon to download the program for free).
NEW PATIENTS ONLY
Prior to your first appointment, please download, complete and bring with you the following PDF forms. These forms can be filled out on your computer by opening them in Adobe Reader (Please click the Adobe icon to download the program for free).
NEW PATIENTS ONLY
It is important that we have good understanding with our patients regarding financial responsibility. We hope this summary will be helpful toward that end. We encourage you to discuss it with us and ask questions if necessary.
ALL PATIENT FORMS
FOR ALL PATIENTS
Authorization for use and disclosure of protected health information. All Medical Records are processed by an outside company (Vital Records). If you need medical records, then please request in writing and allow 7 -10 business days for this to be processed.
Can't Download the Form? Call 214-369-5992
FOR ALL PATIENTS
This Notice of Privacy Practices (the “Notice”) tells you about the ways we may use and disclose your protected health information (“medical information”) and your rights and our obligations regarding the use and disclosure of your medical information.