New Patient Forms


 

New Patient Forms

In order to save time at your appointment, we provide all new patient paperwork below for your convenience. Please bring printed copies to your appointment, or scan and mail them to us in advance.


➣ Patient Information Form

This form allows you to provide us with personal information, including contact details and emergency contacts.

➣ New Patient History Form

This form is intended to collect important medical history so that we are best able to treat you and your unique needs.

➣ Notice of Privacy Practices

This form acknowledges that you have read and understand our privacy practices.

➣ General Consent for Treatment

This form authorizes us to perform the medical treatments necessary to address any issues for which you are seeking care.

➣ Intake History

This is a summary of your medical and surgical history including your allergies, medications, childbirth history, and more.

➣ Patient Authorization to Use or Disclose Protected Health Information

In the event you would like to release medical records to others, such as parents or spouses, this form allows you to authorize us to do so.

Location
Fred A. Williams, MD
1900 Farm Road, #195
Paris, TX 75462
Phone: 903-784-3200
Fax: 903-784-7405
Office Hours

Get in touch

903-784-3200