Patient Resources


 

Patient Resources

New Patients

We know that your time is valuable, and our goal is to provide you with the highest quality care in the most efficient manner. In order to assist us with this, we ask that you please print and complete the forms below prior to your visit with us.

You may present these completed forms upon check-in for your appointment, or fax them to our office beforehand. Thank you for helping make your visit more expedient.

*Fax number: (214)-691-5940 

Disability Forms

Our office requires an annual $25.00 fee for the completion of all disability forms, including FMLA forms. Once this payment has been received and processed, please submit the appropriate forms to our office via fax or in person, and allow up to 15 business days for their completion. You may contact our office at any time to determine the status of your forms during this time. Our office will then fax or mail the completed forms to you upon your request.

*Fax number: (214)-691-5940

Medical Record Requests

The Health Insurance Portability and Accountability Act, also known as HIPAA, was created in 1996 by the US Congress to protect the privacy of your health information. The act prohibits your health care providers from releasing your health care information unless you have provided a signed HIPAA release form. Upon completion of the appropriate form below, please submit the form to our office and we can then release or request your medical information per your consent.

You can fax this form to (214) 691-5940.

Please allow up to 10 business days for this request to be processed. Inaccurate completion of this form will hinder our ability to fulfill your request.

To check the status of a record request, please call our records company

Vital Chart

Phone #: (972) 399-0914

Our Locations

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