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OmniTelamed is launching July 1st, 2021!

Serving fellow Texans from the comfort of their home.

Patient Forms

Patient Registration Forms & Privacy Notices

  • If you are a new patient, please fill out the registration forms listed below in advance of your appointment to assist the staff in making sure that we have all the information necessary to provide you with quality care and treatment.
  • Please bring the completed forms with you to your appointment.

Registration Forms

Please complete one of the forms below

Patient Rights & Responsibilities

We respect our patients’ dignity and pride. This page (link below) will explain your rights and responsibilities as a patient. It is part of your patient registration, and it is an important part of your health care plan.

Privacy Notices

This privacy notice describes how health information about you may be used and disclosed and how you can get access to this information.

  • Notice of Privacy Practices