PATIENT FORMS

If you need a referral from your primary doctor, please make sure that is available by the date of your appointment.
-If you have had any lab or imaging that may be pertinent, please bring the results, or have your prescribing physician fax the results to 713-640-5872.
-Bring a copy of your driver’s license and insurance card to each visit.
-Bring your medication bottles to each visit.

To be filled out:

-New Patient/Change in Demographics

-New Patient Medical History

Telehealth Consent

New Patient Forms, Printable (if not able to fill out online)

To review:

Office Policies

Privacy Practices

MISCELLANEOUS FORMS

Medical Release

Telehealth Consent

COVID-19 Informed Consent To Treat

-Patient Communication Consent