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Liver Specialists of Texas
6624 Fannin, Suite 1990
Houston, Texas 77030
713-794-0700
www.texasliver.com
Joseph S. Galati, M.D.

Patients Name: _______________________

Date of Visit: ________________________

Physician: ___________________________

Specialty: ____________________________

Questions To Ask Physician/Staff

1. __________________________________________________________________

2. __________________________________________________________________

3. __________________________________________________________________

4. __________________________________________________________________

5. __________________________________________________________________

Current Medications

__________________________________________________________________

 Changes in Medication Made Today (Discontinued or Added)

__________________________________________________________________

 

 

New Tests Or Procedures To Be Scheduled/Consultation With New Physicians

__________________________________________________________________

 

Follow-up Appointment: _________________