Call:  972-403-1463

PATIENT INFORMATION

 We accept and file traditional Medicare and most policies secondary to Medicare.  All other patients will be given a receipt at the time of your visit to file to your insurance company for direct reimbursement.

New patients are required complete to the forms below:

New Patient Packet

To be completed before the first visit.

   to fill out the necessary "New Patient" forms (Note: you will be taken to a new secure window)

Follow Up Packet

To be completed after the first visit.

   to fill out the necessary "Follow Up" forms (Note: you will be taken to a new secure window)

IMPORTANT

  • You cannot complete these forms more than 2 days in advance.
  • These forms must be filled online and cannot be printed. When you arrive at your appointment, you can request a printed copy for your records.
  • Please avoid closing your browser window until the final submission of the patient's data at the end. If you accidentally close your browser window, then you can come to our office to complete the forms.

ADDITIONAL PATIENT NEEDS:

APPOINTMENTS

To schedule an appointment please fill out the form below and allow up to 48 hours for our office to process your request.

Appointment Request or Change
Sending

REFILL REQUEST

Refill Requests Form
This option is for established patients only. Please allow up to 48 hours for our office to process your request.

Refill Requests and Questions
Sending

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