Patient Forms

Patient information and consent forms are a necessary part of receiving appropriate medical care. In order to save you time at your visit, please feel free to print off the consent forms below and read and sign them before arriving for your appointment. After completing them you can either bring them with you to the visit or fax them to us: 214-260-0986. You will also need to complete our Patient Registration form, Patient Health History forms (Part 1 of 2 and Part 2 of 2), and our Review of Systems form. In order to complete these forms you will need to create an account with our Secure Patient Portal and you’ll find these four forms on the “Health Forms” page within the portal. You can create your portal account by clicking on the “Secure Patient Portal” link listed above on our website.

Consent Forms:

• Patient Registration Form

Additional Forms (Print only as needed)

• To read the POSM Notice of Privacy Practices (click here)
• Consent to Medical Treatment of a Minor (Download here)
• Release of Medical Records (Download Here)
• MRI Testing (only if having your MRI at POSM – (Download Here)
• Para formas en espanol (Descarque aqui)

Elsewhere on this website you can find information on the following:

• Conditions Treated
• Location
• First Visit
• Referral Form
• Insurance Info
• Appointments

You will need the Adobe Reader to view and print these documents.