Patient Forms
Here are a couple of our patient forms for your review. Please download and print form if needed. Do not e-mail completed forms with protected health information. You can bring the form to your appointment of fax the document to 806-744-7241.
You can click on these links to directly fill out a
The information will be directly submitted to our office database. The server is secure (https) and your information is protected.
You can click on these links to directly fill out a
The information will be directly submitted to our office database. The server is secure (https) and your information is protected.

patient_information_med_history.pdf | |
File Size: | 220 kb |
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patient_information_med_history_spanish.pdf | |
File Size: | 237 kb |
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general_consent.pdf | |
File Size: | 368 kb |
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sedation_instructions.pdf | |
File Size: | 303 kb |
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notice_of_privacy_practices.pdf | |
File Size: | 59 kb |
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post_operative_sedation_instructions.pdf | |
File Size: | 208 kb |
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covenant_surgicenter_instructions.pdf | |
File Size: | 152 kb |
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lkd__post_surgery_instructions_english_.pdf | |
File Size: | 328 kb |
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lkd__post_surgery_spanish.pdf | |
File Size: | 216 kb |
File Type: |