patient forms  Arlington, TX

ALL PATIENTS PLEASE BRING…..

1. Your insurance card and copay for specialist doctor visit.
2. Some form of valid picture identification.
3. X-Ray and/or MRI films/CD’s and reports.

There is a fee of $25 for all appointments that are missed without 24 hour notification of cancellation.

Patients are responsible to get referrals from their PCP for HMO insurances.

PATIENT FORMS

You may fill out the new patient information packet and bring them with you to your appointment.

You may also fill out the authorization to release medical records form if you need to request records from another physician to be faxed to our office.

CLICK ON THE LINKS BELOW TO DOWNLOAD A COPY OF THE FORMS.

Forms in English for Dr. Christine Huynh and Dr. Henry Chou
For appointments with Dr. Christine Huynh and Dr. Henry Chou, please print, fill out these forms and bring with you to your appointment.
New patient Information Packet

Form in English for Dr. Paul Chong, Dr. Jacob Chun and Dr. Christopher Wong
For appointments with Dr. Paul Chong, Dr. Jacob Chun and Dr. Christopher Wong (Orthopedic Surgeon),  please fill out these pages:
New patient Information Packet

Authorization form to Release Medical Records

For Dr. Huynh Cosmetic patient please fill out the below forms 

Botox and Cosmetic Fillers Consent Form

FORMS IN SPANISH (Formas En Espanol), Por Favor Llene Todas Las Formas:

Para citas con la Dr. Christine Huynh rellene estas paginas:
Formas Para Nuevos Pacientes

Para citas con el Dr. Christopher Wong o Dr. Paul Chong cirujano ortopedico, rellene estas paginas:
Formas Para Nuevos Pacientes

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