» Personal Profile
» Patient Info
» Contact Us
» Patient Forms
1125 S. Henderson
Ft Worth, TX
Parking on premise: FREE
Office Hours: By appointment only.
Monday - Friday 8:30 a.m.- 4-:30 p.m.
Click here for Map
Please Click on the forms below to download and Print...
Personal History Form
Patient Consent Form HIPPA
Patient Communication Preferences HIPPA
Information for my patients
As Required by the Privacy Regulations Created as a Result of the Health Insurance Portability and Accountability Act of 1996 (HIPAA)
THIS NOTICE DESCRIBES HOW HEALTH INFORMATION ABOUT YOU (AS A PATIENT OF THIS PRACTICE) MAY BE USED AND DISCLOSED, AND HOW YOU CAN GET ACCESS TO YOUR INDIVIDUALLY IDENTIFIABLE HEALTH INFORMATION.
Developed, Designed and Powered By Integrated Digital Solutions.