Skip to main content
Located on 827 East Lamar Blvd in Arlington, TX
Menu


Home » Contact Us » Patient Forms

Patient Forms

Please complete the form below and submit it online, or if you prefer, you may print out the form after full or partial completion and bring it when you come to our office. This form contains confidential information and is delivered to your doctor through a secure Internet connection.

Also, please take a moment to print and complete these forms to bring with you to your next appointment. This will help us to reduce your waiting time.

Print Forms Online Forms
Medical History Medical History Print Form Medical History Online Form
Insurance Worksheet
Insurance Worksheet Print Form

Insurance Worksheet Online Form

Required Signatures Required Signature Print Form Required Signature Online Form
HIPAA Acknowledgment

HIPAA Print Form

HIPAA Online Form

Optomap Agreement Optomap Agreement Print Form Optomap Agreement Print Form