At Breast Surgery Center of North Texas, we understand that you want your appointments to run as smoothly as possible. To streamline your first visit, our patient forms are available online.
Simply click on the links below to download, print, complete and bring the forms to your appointment. In order to protect your privacy, please do not email forms.
- New Patient Registration Form: English | Espanol
- Consent to Treat: English | Espanol
- Medical History and Physical Form: English
- Medical Release of Information: English | Espanol
Note: The forms are saved in Adobe® Acrobat. If you would like to read, use the form features or print the Adobe files, you will need the Adobe® Reader (version 5.0 or later). Download Adobe Reader for free.
We believe in enabling our patients to focus on maintaining good health and receiving quality care. Breast Surgery Center of North Texas accepts most major insurance plans and will verify benefits prior to your appointment. Please call us at 972-747-6401 with any questions.
Pay a Bill
In order to use the payment portal to pay your bill, please have your statement and billing information readily accessible. For question or payments by phone, call us at 1-800-890-6034.
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