Download New Patient Forms | AXIS

To expedite your appointment and save you time in the office, we have provided our patient forms below. Please print and complete each form before your appointment and bring the forms with you to your appointment or fax them to 817-502-7412.

Complete Forms Packet

• Forms Packet
• Financial Policy
• HIPAA Notice of Privacy Practices
• Patient Rights and Responsibilities

Individual Forms

If you need an individual form from the Complete Patient Packet above, each form is found below.

• Patient Information
• Medical History
• Pain Medication Policy
• Out of Pocket Payments Form
• Disclosure of Protected Health Information
• Authorization for Use or Disclosure of Protected Health Information
• Acknowledgement Form

Privacy Terms

• HIPAA Notice of Privacy Practices