Telemedicine Registration

Patient Forms

For your convenience, common patient forms can be viewed and filled out in advance of your visit.

Registration Form

Telehealth Informed Consent

HIPAA Authorization and Notice of Receipt of Privacy Practices

Assignments of Proceeds and/or Lien For Medical Services

Telemedicine Consent

Telephone Consent Form

 

Medical Records

 

Patient records are held in a digital format and aggregated into an Electronic Health Record (EHR).

Electronic Health Records bring many benefits:

  • Secure and private
  • Accessible at all locations
  • Files unified for complete record
  • Environmentally sound

Fax : 713.984.8481

Address: 8301 Katy Fwy • Suite 101 • Houston, TX 77024