To ensure that your visit to our office is as convenient and efficient as possible, we are pleased to offer our HIPAA and Patient Registration forms on-line. These forms may be printed, filled out manually, and brought with you to your first visit.

 

Downloadable Forms

 New Patient Packet 

 New Patient Packet - Spanish

Health History Forms

Comprehensive Evaluation Form - Geriatrics

 Health History Questionnaire - Dermatology (For DDA-Plano only)

Health History Questionnaire - Dermatology, Dr. Christy Riddle

Health History Questionnaire - Endocrinology

Health History Questionnaire - GI

Health History Questionnaire - Internal Medicine

Health History Questionnaire - Neurology

Health History Questionnaire - Pulmonary

Health History Questionnaire - Rheumatology

Radiology Forms

 Radiology - CT Patient Information Form

Radiology - MRI Abdomen Questionnaire

 Radiology - MRI Head Questionnaire

 Radiology - MRI Musculoskeletal & TMJ Questionnaire

 Radiology - MRI Patient Screening Form

 Radiology - MRI Spine Questionnaire

 Radiology - Osteoporsis Questionnaire

 Radiology - Patient Information for Diabetics Taking Glucophage/Metformin

 Radiology Contrast History Form 1

 Radiology Contrast History Form 2

 Radiology Contrast History Form 3

Legal and Policy Forms

Advance Directive

Authorization for Release of Information from Dallas Diagnostic Association

Authorization for Release of Information to Dallas Diagnostic Association

 Declaration for Mental Health Treatment

 Dermatology - For DDA Garland patients Only

 Do Not Resuscitate Order

Medical Power of Attorney

Medicare Wellness Visit

 Uniform Donor Form