Your New Patient Package & First Visit Checklist
Click to download your New Patient Package.
Click here to fill out the New Patient Package online.
To better serve you during your initial visit please download, print, complete and bring your new patient forms with you to your appointment. All pages except for the patient portal consent form must be filled out before the appointment. We ask that you bring the following items on your first visit: your health insurance card and photo ID; any medical records such as lab reports, imaging results and physician notes; and a list of your current medications
In order to view or print these forms you will need Adobe Acrobat Reader
installed. Click here to download it.
Your New Patient Package includes:
- Patient Demographics
- Insurance Information
- Financial Responsibility Agreement
- Informed Consent
- Notice of Privacy Practices
- Authorization for Release of Medical Records
- Office Policies
- Patient Portal Consent Form
Click here to download the Notice of Privacy Practices
If you have any questions prior to your appointment, please call the office at (210) 591-0688.
Notice Concerning Complaints
Complaints about physicians may be reported for investigation to the following address:
Texas State Board of Medical Examiners
Attention: Investigations
333 Guadalupe,
Tower 3, Suite 610
P.O. Box 2018,
MC-263
Austin, TX 78768-2018
Assistance in filing a complaint is available by calling the following telephone number: 1-800-201-9353.
For more information, please visit www.tmb.state.tx.us .