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 Physician Profile |
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Adult New Patient
For adults (age 18+) with a new patient appointment
Full Packet | Required Pages Only
Formato Completos | Formato Requeridos
Pediatric New Patient
For children (age less than 18) with a new patient appointment
Full Packet | Required Pages Only
Formato Completos | Formato Requeridos
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.
(Para obtener este formulario en español, por favor oprima aquí)
Authorization to Release Medical Information TO MCNT
Form authorizing healthcare provider to release your medical information to Medical Clinic of North Texas, P.A.
(Para obtener este formulario en español, por favor oprima aquí)
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Authorization to Release Medical Information FROM MCNT
Authorizes Medical Clinic of North Texas, P.A. to release your medical information to specific entities.
(Para obtener este formulario en español, por favor oprima aquí)
HIPAA Patient Education - Frequently Asked Questions
HIPAA as it relates to our patients.
(Para obtener este formulario en español, por favor oprima aquí)
Request for Correction / Amendment to Record
Allows you to request a correction / amendment to your medical record.
(Para obtener este formulario en español, por favor oprima aquí)
Know Your Benefits
This pamphlet can assist you in learning about your insurance benefits, including questions to ask your provider.
(Para obtener este formulario en español, por favor oprima aquí)
Financial Policy
Explains payment of services
(Para obtener este formulario en español, por favor oprima aquí) |
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 24-Hour Pharmacies |
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| Walgreens |
CVS |
3100 Mccart St.
Fort Worth, TX 76110
(817) 924-5126 |
3614 Camp Bowie Boulevard
Fort Worth, TX 76107
(817) 870-1873 |
6205 Westcreek Dr.
Fort Worth, TX 76133
(817) 263-0962
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2603 West Berry St.
Fort Worth, TX 76109
(817) 923-8259 |
6244 Lake Worth Blvd.
Lake Worth, TX 76135
(817) 238-0385
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8660 US Highway 377 South
Benbrook, TX 76126
(817) 249-4040 |
4520 Western Center Blvd.
Haltom City, TX 76137
(817) 514-8063 |
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9625 White Settlement Rd.
Fort Worth, TX 76108
(817) 367-3469 |
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6984 Rufe Snow Dr.
Fort Worth, TX 76148
(817) 427-9353 |
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1317 S. Main
Weatherford, TX 76086
(817) 594-5771
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4520 Western Center Blvd.
Haltom City, TX 76137
(817) 514-8063
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1050 E. Hwy 377
Granbury, TX 76048
(817) 578-3120
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 Services Offered |
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 Hospital Affiliation |
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Our Family Medicine physicians offer healthcare services for all the members in your family -- infants, women, men and children. Services include annual health exams, well visits, immunizations, screenings and preventive care.
In addition, many of our physicians set their schedules to accommodate same-day sick visits.
To learn more about Family Medicine, please visit the American Board of Family Medicine at http://www.theabfm.org/. |
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- New Patients Always Welcome
- Same-Day Sick Visits Available
- Accepts Most Major Insurance Plans and Medicare
- Health Care for the Whole Family, Newborns and Older
- Sports, School, Annual Physicals
- Labs & Immunizations
- Gynecological Exams, Family Planning
- Diabetes Screening and Counseling
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Texas Health Fort Worth Hospital
1301 Pennsylvania Avenue
Fort Worth, TX 76104
817-250-2000
www.texashealth.org |
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. All rights reserved. Site designed and developed by the Medical Clinic of North Texas, P.A. |
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Location
Biography - DR. R. KENDRA DABELIC 
Other Physicians at this Location
