Patient Forms

Please select the form you need to complete. Your progress is automatically saved as you proceed.

Harlingen:956-421-2757 (8:00 am to 5:00 pm)
Weslaco:956-619-8000 (8:00 am to 5:00 pm)

New Patient Registration

Complete this form to register as a new patient

Estimated time: 10-15 minutes Auto-saves as you type

Medical Records Release

Request your medical records

Estimated time: 5 minutes Auto-saves as you type

HIPAA Privacy Consent

Review and acknowledge our privacy practices

Estimated time: 3 minutes

Treatment Consent

Consent for medical treatment

Estimated time: 5 minutes

Financial Policy

Review our financial policies and procedures

Estimated time: 4 minutes
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