PATIENT FORMS

To expedite your visit please complete the Patient Registration, Office Policies, and Medical History forms. In addition Medicare patients should also complete the Medicare Screening for Coordination of Benefits. Completed forms should be submitted to our office 48 hours prior to your appointment. All forms can be faxed to our confidential fax at 817-886-3612.

IT IS NECESSARY FOR YOU TO COMPLETE ALL 3 FORMS (4 IF MEDICARE) TO EXPEDITE CHECK-IN FOR YOUR APPOINTMENT!

Patient Registration Form 

Office Policies

Medical History

Medicare-only Patient Screening

HIPAA 2008

Insurance Contract Lists

Forms in Spanish (Forma de Registro del Paciente)