604 Southeast Parkway, Azle, Texas 76020 Phone: 817-270-2320
Azle Pediatrics
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New patient forms
New Patient forms
The documents below are in pdf form using adobe acrobat reader 7.0. To download an update for the adobe reader, click here.
Assignment of Medical Care --- required if someone other than the parent or guardian will be bringing the child to an appointment
Initial History --- required at first visit
Office Policies --- required at first visit
Privacy Practices --- to be reviewed for first visit. Also available to be read in the office.
Medical Records Release Form --- required if making a records transfer request
Patient Profile --- required at first visit
