Please visit our central patient information page for information on insurance, pay online, billing, hotel/motel guide, customer service, privacy practices (HIPAA), and forms including general health, Authorization for Release of Protected Health Information (medical records), and Patient Relationship Agreement.
Family Medicine Forms
Save time by filling out forms before you arrive. Each form can be printed for completion.
New patient forms. The General Intake Form can be filled out and submitted online if you have a MyChart account. If you have any questions regarding new patient forms, please call (713) 798-7700.
Authorization for Release of Protected Health Information (medical release form).
A completed and signed Authorization for Release of Protected Health Information form can be sent to our Release of Medical Records department as follows:
Phone: (713) 798-5259
Fax: (713) 798-1464
Address: Two Greenway Plaza, Suite 900, Houston, TX 77046
Most appointments can be made within 24 to 48 hours.
- Current Family Medicine patients can schedule appointments by visiting MyChart.
- New patients should call (713) 798-7700 to make an appointment.