Patient Forms

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To schedule an appointment,
call 214-942-5511.

Once you have made your initial appointment, you can preregister by downloading the PDF New Patient forms. Please fill out these forms prior to your arrival. Please bring the completed and signed forms with you to your upcoming appointment. This will help speed up the new patient registration process and get you in to see the doctor faster.

New Patient Online Forms

ENGLISH FORMS
New Patient

 

  • New Patient Welcome Letter | PDF
  • New Patient Information  | PDF
  • Patient Registration Form | PDF

MORE FORMS

  • Consent to Release Information  | PDF
  • Notice of Privacy Practices | PDF
  • No Show Fees Form  | PDF
  • General Information with Map | PDF
  • Patient Financial Policy Sheet | PDF
  • Referral Information | PDF

Paciente Nuevo: Formularios En Español

  • Registracion para paciente nuevo (Español)
    | PDF
  • Informacion Del Paciente
    | PDF

Formularios En Español

  • Poliza de Cancelacion
    | PDF
  • Forma de Autorizacion Para Revelar Informacion de Salud Protegina | PDF

In addition to new patient forms, there are several forms for the tests we offer. If your physician orders one of these tests, please call our office to have one sent to you.

Please note: If you are unable to view the forms, you may need to download Adobe Acrobat.