Please email to email@example.com at least 48 hours before your visit.
English: New Patient Registration Form
Spanish: Formulario de registro de pacientes nuevos
- Texas VFC Patient eligibility Screening Form (only for Uninsured patients & Government insurance like Medicaid)
- Medical Release Form for Minors Attending with a Non-Legal Guardian (Fill only if a non-legal guardian will bring the child)
To speed up your visit, please fill up and fax the forms to 972-618-3547 or scan the completed forms and email to firstname.lastname@example.org at least 48 hours before your visit.
Before Your Appointment
- Understand Your Insurance – A simple and easy to understand primer on Insurance.
- Understanding Preventative / Well Visits – What your Insurance means by a Well visit (also what it DOES NOT cover)
- Important information to know before your Office Visit – What you must know before your Office Visit