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Patient Forms
We understand you want to have your office visit run as smoothly as possible. To help facilitate this process, we have provided our new patient forms here for you to download and complete before your first visit.
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 e-mail forms.
- Patient Registration Form | Registro del Pacientes
- Consent to Treat Form | Consentimiento Para Recibir Atención Médica
- Patient History Form | Historia De Salud del Paciente
- Patient Release of Information Form | Autorización Para Divulgación Información del Paciente
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.
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Insurance Information
We believe in making it easy for our patients to focus on their treatment and regaining good health. Texas Health Surgical Care accepts a wide range of insurance plans and various forms of payment, and will verify benefits prior to your appointment. Please call us at 817-250-7280 if you have any questions.
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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.