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FOR NEW PATIENTS


PLEASE PRINT ALL FORMS BELOW

EITHER FAX: (281) 480-2407

OR 

EMAIL: [email protected]

BEFORE YOUR INITIAL APPOINTMENT



Consent for Treatment

Insurance Benefit Information

Telemedicine Consent Form

When doing video visits, we ask that you not drive and be appropriately dressed for appointments. If the vehicle is moving while the patient or guardian is driving, the call will end, and applicable charges will apply.‚Äč

Consent for to Release Information to PCP

Notice of Privacy Practices (HIPAA)

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