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We appreciate having the opportunity
to serve you. For your convenience, you will find below a number of forms
which you may print off and complete in advance of your visit to our
office. You may bring the completed forms with you, or you may fax
them to our office manager at 972.664.0381.
Adult patients should complete items
#1 and #2.
Parents of child patients should
complete forms #1and #3.
Individuals requesting that
information be released to a special third party may complete form #4.
1. Office Policies and Procedures
2. Adult
Patient Information
and History Forms
3. Minor
or Dependent Child
Information Form
4. Consent
for Release of
Confidential Information
5. Consent
for Treatment
of Minor Dependent
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a Free Adobe PDF Reader
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