Bariatric Evaluation Counseling
Dr. Jane Counts provides counseling to persons who are interested in bariatric surgery procedures. The counseling is geared at preparing patients for the emotionally-related issues associated with the surgery. For more information, click on the ARROW in the picture above to play the video.

View Dr. Kim Videos
We invite you to view these videos to learn more about our bariatric surgery procedures and our comprehensive approach to treatment and follow-up care. Our video segments will introduce you to Dr. Kim, our staff members, and patients as they describe what sets the Live Life Again Center for Bariatric Surgery apart from other practices in the Dallas-Fort Worth area.

Please, click here: www.Dr.D.Kim.net

Adult New Patient
For adults (age 18+) with a new patient appointment
Full Packet | Required Pages Only

Receipt and Notice of Privacy Practices (HIPAA)
HIPAA requires all patients to complete this form. Describes how medical information about you may be used and disclosed and how you can access this information.

Authorization to Release Medical Information TO MCNT
Form authorizing healthcare provider to release your medical information to Medical Clinic of North Texas, P.A.

Authorization to Release Medical Information FROM MCNT
Authorizes Medical Clinic of North Texas, P.A. to release your medical information to specific entities.

HIPAA Patient Education - 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

Para obtener estos formularios en español, OPRIMA AQUÍ.

Jane A. Counts, Ph.D. is a Licensed Clinical Social Worker - LCSW

• I was born and raised in Lubbock and Midland, and spent much of my adult life in El Paso, Texas. I returned to Lubbock in 1993 as a faculty member in The Department of Family and Community Medicine. I continue to work with some of my dearest friends, from that clinical experience, here at MCNT. This is the finest group of physicians that I have ever known.
• Midland Lee High School
  Midland, Texas

• Texas Tech University
  Bachelor of Arts
• The University of Texas at Austin
  Master of Science in Clinical Social Work and Administration and Planning
• Newport University
  Doctor of Philosophy in Human Behavior
• I spend most of my free time gardening, knitting, reading and playing with horses. My faith and family is central in my life. I care deeply about my patients and their experiences in life.

• Private Practice Psychotherapy – Advanced Clinical Practitioner – 1994 - 2006
• Specializing in Individual, Marital, and Family Therapy and Acute Intervention; Obesity, Weight loss and Psychological Evaluation for Laparoscopic, Bariatric Surgery for Weight Loss; Bereavement, Grief, and Loss.
• Diplomate of the American Psychotherapy Association
• Certified Christian Counselor
• Advanced Clinical Practitioner
• Licensed Master Social Worker -- LCSW

• Assistant Professor of Human Behavior – Texas Tech University Health Sciences Center – Lubbock, Texas 1999 – 2003.
• Co-Director of Behavioral Science in Residency Education – The Department of Family and Community Medicine, TTUHSC, Lubbock, Texas – 1993 – 2003
• Course Director – Texas Tech University School of Medicine – First Year Medical Students: 2000 - 2003
• Clinical Associate and Clinical Instructor, Third-Year Medical Students – Texas Tech University Health Sciences Center – Lubbock, Texas 1993 – 1999
• Private Practice Psychotherapy – 1993 – 1994 Internship

6205 Westcreek Dr.
Fort Worth, TX 76133
(817) 263-0962

2603 West Berry St.
Fort Worth, TX 76109
(817) 923-8259

6244 Lake Worth Blvd.
Lake Worth, TX 76135
(817) 238-0385

4520 Western Center Blvd.
Haltom City, TX 76137
(817) 514-8063

9625 White Settlement Rd.
Fort Worth, TX 76108
(817) 367-3469

1317 S. Main
Weatherford, TX 76086
(817) 594-5771

4520 Western Center Blvd.
Haltom City, TX 76137
(817) 514-8063

1050 E. Hwy 377
Granbury, TX 76048
(817) 578-3120