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Patient Forms

The paperwork we ask for, what each form is used for, and how to complete it before you arrive.

Patient Forms

Paperwork, Handled Before You Arrive

Completing your forms ahead of the visit means less time at the front desk and more time with your cardiologist. It also gives the physician your history before you walk in, which makes the consultation more useful.

Our team can send the forms to you by email once your appointment is booked, or you can arrive 15 minutes early and complete them in the office.

If anything on a form is unclear, leave it and raise it at your visit. Nothing is more useful than an accurate answer given in person.

The Forms

Forms We May Ask You to Complete

Which forms apply depends on whether you are a new patient and what your visit involves. Our team will tell you exactly what is needed when you book.

New Patient Registration

Your contact details, emergency contact, primary care physician, and preferred pharmacy — the basics we need to open your record.

Medical History

Past conditions, surgeries, family history, and current symptoms. This is the form worth taking time over, because it shapes the consultation.

Medication List

Everything you take including doses, plus vitamins and supplements. Photographing your bottles is an easy way to get this exactly right.

Insurance and Financial

Your policy details and assignment of benefits, so we can verify coverage and bill correctly.

Notice of Privacy Practices

Your acknowledgement of how your health information is used and protected under HIPAA.

Records Release

Authorization for us to request prior test results from other physicians, or to send your records where you direct.

How to Submit

Completing and Returning Your Forms

Whichever way suits you — the aim is simply that we have them before your appointment starts:

Ask our team to email the forms when you book
Complete them at home and bring them with you
Arrive 15 minutes early and complete them here
Bring photo ID and your insurance card either way
Include prior test results if you have them
Sign the records release so we can request past results
Call us if any question is unclear

Please do not email health details

Ordinary email is not a secure way to send medical information. Bring completed forms with you, or call our office and we will arrange a secure method.

Visit Us
10905 Memorial Hermann Drive, Suite 203, Pearland, TX 77584
Downtown Houston — serving the Texas Medical Center, Midtown, and Downtown
Monday–Friday, 8:00 a.m. – 4:30 p.m.
(346) 614-0002
FAQ

Frequently Asked Questions About Forms

Still have questions?

Talk to our office — Monday to Friday, 8:00 a.m. to 4:30 p.m.

Call (346) 614-0002

Our team sends them once your appointment is booked. Call (346) 614-0002 if you have not received them, or arrive 15 minutes early and complete them at the office.

Yes. Arrive about 15 minutes early and our front desk will get you started.

Please do not send health information by ordinary email, as it is not secure. Bring them with you, or call us and we will arrange a secure alternative.

Photograph your medication bottles and bring the photos, or bring the bottles themselves. Doses matter as much as names.

Usually not. We will ask you to confirm your medications and any changes since your last visit.

It lets us request prior ECGs, echocardiograms, stress tests, and laboratory results from your other physicians so your cardiologist can compare against them.

Complete what applies to you. If a question is unclear or does not fit your situation, leave it and raise it at the visit.

Yes. Bring a family member if that helps, and our front desk team is happy to assist.

Need Your Forms?

We will send them as soon as your appointment is booked.

Request an appointment online or call (346) 614-0002, and our team will confirm which forms apply to your visit and get them to you.

Request an Appointment

New patients are welcome.

Serving patients throughout Pearland, Greater Houston, and surrounding areas.