Please click on the links below to view and print the patient forms. You must also read the “Notice of Privacy Practices”, and print and sign the “Acknowledgement of Review of Notice of Privacy Practices”. Please fill out the forms entirely with all signatures. To help expedite the administrative process and to help ease your wait time, you can either fax them to our office ahead of time (936- 788- 2844) or bring them with you to hand in when you arrive for your scheduled appointment.
Registration and Health Assessment (print, complete and sign)
Assignment of Benefits Form (print, complete and sign)
Preventative & Diagnostic Labs (print, complete and sign)
Medical Records Release Form (print, complete and sign)
Notice of Privacy Practices (READ ONLY)
Acknowledgment for HIPPA Form (print, complete and sign)
PHQ-9 Patient Health Questionnaire (print, complete and sign)
Audit C Alcohol Screening (print, complete and sign)
PA & NP Consent Form (print, complete and sign)
Patient Centered Medical Home Patient Compact (print, complete and sign)