At Plastic and Hand Surgery of North Texas, we understand you want to have your office visit run as smoothly as possible. To help facilitate this process, we have provided our patient forms online for you to download and complete before your visit.
Simply refer to the list below to find the patient form(s) you need, then click on the link to download, print, complete and bring them to your appointment. In order to protect your privacy, please do not email these forms.
- New Patient Registration Form: English | Español
- Patient History Form: English | Español
- Medical Release of Information Form: English | Español
We accept most major insurance policies as well as Medicare and will verify benefits prior to your appointment. However, we recommend you contact your individual insurance provider for benefit coverage prior to your appointment.
Patients are seen by appointment only. Please schedule an appointment during regular business hours. If you must cancel your appointment, please notify the office at least 24 hours in advance and we will be happy to reschedule your visit.
Your first appointment is for an initial visit/consultation. In most cases, surgery will not be performed at the time of this initial visit but will be scheduled for a later date.
Prescriptions and prescription renewals should be completed during a regular office visit. Please call us for renewals and to address any non-medical problems during regular office hours. We regret that we cannot provide prescriptions after hours or on weekends.
Emergency calls after regular business hours are handled by an answering service through our office number.
- Blank forms will not be accepted. Personal information must be completed.
- Turnaround time is usually 4 business days.
- Form Fee – There will be a $25 fee charged for specialized forms that are filled out by the doctor. (FMLA papers, insurance forms, disability determination forms, and medical necessity forms)
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 1-855-602-5273.
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