Adult New Patient For adults (age 18+) with a new patient appointment
Pediatric New Patient For children (age less than 18) with a new patient appointment
Notice of Privacy Practice Describes how medical information about you may be used and disclosed and how you can access this information.
Receipt of Notice of Privacy Practices HIPAA requires all patients to complete this form.
Medical Release Form authorizing healthcare provider to release your medical information to Medical Clinic of North Texas, P.A.
Medical Information Release Authorizes Medical Clinic of North Texas, P.A. to release your medical information to specific entities.
Frequently Asked Questions HIPAA as it relates to our patients.
Request for Correction / Amendment to Record Allows you to request a correction / amendment to your medical record.
Know Your Benefits This pamphlet can assist you in learning about your insurance benefits, including questions to ask your provider.
Financial Policy Explains payment of services
