Patient Resources

We know that your time is valuable, and our goal is to provide you with the highest quality care in the most efficient manner. In order to assist us with this, we ask that you please print and complete the forms below prior to your visit with us.

You may present these completed forms upon check-in for your appointment, or fax them to our office beforehand. Thank you for helping make your visit more expedient.

*Fax number: (214)-691-5940

 

Patient Handouts

The following documents are available for our patients and provide detailed instructions and information in the treatment of some of the most common foot and ankle conditions.

 

Disability Forms

Our office requires an initial $20.00 fee for the completion of all disability forms, including FMLA forms. Once this payment has been received and processed, please submit the appropriate forms to our office via fax or in person, and allow up to 10 business days for their completion. You may contact our office at any time to determine the status of your forms during this time. Our office will then fax or mail the completed forms to you upon your request.

*Fax number: (214)-691-5940

 

Medical Information Release Forms

The Health Insurance Portability and Accountability Act, also known as HIPAA, was created in 1996 by the US Congress to protect the privacy of your health information. The act prohibits your health care providers from releasing your health care information unless you have provided a signed HIPAA release form.

Upon completion of the appropriate form below, please submit the form to our office and we can then release your medical information per your request and consent.

In order to have your medical records sent from our office to another entity, please complete the form below and submit to our office. Please allow up to 7 days to process your request.

In order to have your medical records sent to our office, please complete the form below and submit to our office. We will send this request to the appropriate entity to obtain the specified medical records. Please allow up to 7 days to process your request.

*Fax number: (214)-691-5940