| Patient Forms |
Below are the forms that you will need for your first visit with us. Please click on each link and then print each form individually. You will have four pages once complete. At this time the paperwork cannot be submitted via the web. Please make sure you print each page before you navigate to the next one.
Patient Information English En Espaņol
Benefit Release English En Espaņol
Patient Representative Authorization English En Espaņol
Health History English En Espaņol
For a Map and Insurance List click the links below
Directions
If you are coming from the Fort Worth Area
Travel East on 183 (Airport Freeway)
Exit Central Drive and head North onto Central Dr. at the light (turn left and go under freeway)
At the First Light (L Don Dodson Drive) head West (left turn) (there is a QT Gas Station on the corner)
We are the 3rd building on the South side of the street (single story building on the left)
The Sign on the street says "Bedford Medical Plaza"
Once you park, enter the building at the East entrance (left front of building)
We are in Suite 105
If you are coming from the Dallas Area
Travel West on 183 (Airport Freeway)
Exit Central Drive and turn North onto Central Dr at the light (turn right)
At the First Light (L Don Dodson Drive) head West (left turn) (there is a QT Gas Station on the corner)
We are the 3rd building on the South side of the street (single story building on the left)
The Sign on the street says "Bedford Medical Plaza"
Once you park, enter the building at the East entrance (left front of building)
We are in Suite 105