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1252 Harwood Road Bedford, TX 76021
Call Us: (817) 284-1496
Patient Information Form
Patient History Form
HIPAA Authorization of Use and Disclosure
Financial Policy
Only if Pregnant-Ob Questionnaire
Outpatient Post-op Instructions
Major Post-op Instructions
General Surgery Pre-op Instructions
Commonly Asked Questions
Female BHRT Checklist
Female Hormone Replacement Fee Acknowledgment
Female Patient Questionnaire History
Female Pellet Acknowledgment
HIPAA Inform and Consent Form
Insurance Disclaimer
Symptom Sheet Female and Male
Commonly Asked Questions for Males
HIPPA Inform and consent Form
Male Hormone Replacement Fee Acknowledgment
Male Patient Questionnaire History
Male Testosterone Acknowledgment
Symptoms Sheet
Medical Records Release TO Dr. Safely
Medical Records Release FROM Dr. Safely