New Patients

All new patients must fill out patient information sheets. Please print the completed forms and bring them with you at your appointment.

Patient Registration and Insurance Form

• Print the form

  or

• Complete it online

Financial Policy Agreement Form

• Print the form

  or

• Complete it online

Receipt of Privacy Practices Notice Written Acknowledgement Form

• Print the form

  or

• Complete it online

Records Release Form

• Print the form

Patient Consent to Disclose Private Health Care Information HIPAA Form

• Print the form

  OR

  • Complete it online

ImmTrac: Texas Immunization Registry Form

• Patients UNDER 18

  • Print the form

    or

  • Complete it online

• Patients OVER 18

  • Print the form

    OR

  • Complete it online

HIPAA:

We abide by the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”). Please read this document to understand your rights under the HIPAA privacy rules:

HIPAA PDF Document

TELEHEALTH CONSENT:

• Print the form

  or

• Complete it online