909 Southeast Parkway, Suite 101, Azle, Texas 76020 Phone: 817-237-9225
Azle Pediatrics
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New Patient forms
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
