Liver Specialists of Texas: Patient Forms
New patients that have been scheduled an appointment with Dr. Galati can download the following forms needed for proper processing and documentation. To save time the day of your visit, it is best if they are filled in ahead of time and bring them with you the day of the appointment. This will reduce the amount of time filling out forms in the office.
ALL NEW PATIENT FORMS
These forms include the following items:
- General introductory letter about our practice
- Insurance plan information
- HIPPA Form (Disclosure of Health Information). For more information on HIPPA, click here.
- Basic Health Questionnaire
- Office Policies (requires signature)
- Practice Financial Policy
- Use of E-Mail Communication
- Medical Release Form (this will allow us to review your records from other physicians and facilities)
If you have any questions regarding these forms, feel free to contact Liver Specialists of Texas at 713-794-0700. Our staff will be happy to assist you.
Additional patient forms are posted below.