To become a new patient please complete the HIPAA-compliant forms below BEFORE requesting an appointment.

***MAKE SURE TO CHECK WITH INSURANCE TO VERIFY YOU ARE IN-NETWORK WITH THE DOCTOR BEFORE COMPLETING ANY FORMS***

Upon completion of the required forms, our staff will create your new patient chart and reach out to you to arrange your appointment.

(If you have any questions call us at (469) 447-8730)

1. Patient Demographic
2. Child Health History
3. Consent to Treat
4. Patient Responsibility/Financial Agreement
5. HIPAA Form & Privacy Notice
6. Wellness Care ACA
7. Medical Release