Become a Patient

Become a New Patient

We are currently accepting new patients into our practice. Thank you for considering us. To become a new patient:

When you come to our office for the first time as a new patient, we’ll ask you to complete some initial forms, including a Consent for Treatment form, if you were not able to download them in advance of your appointment.

To make sure there are no delays in care during your first visit experience, please arrive 15 minutes prior to your scheduled appointment to ensure your registration is complete before meeting with your new provider.

Remember to bring:

  • Your insurance card
  • Valid photo ID
  • List of current medications
  • Office co-pay

In an effort to respect the time of all of patients, our staff strives to stay on schedule so that other patients do not have to wait.

For patients who are delayed and arrive late for appointment, every effort will be made to see them the same day. However, wait times may apply, or appointments may need to be rescheduled.

Patient Forms

We’re honored you have chosen Touchstone Internal Medicine and Pediatrics for your family’s medical care. To schedule an appointment, please call us at 214.239.1053. Once you have made your initial appointment, you may pre-register by downloading, printing, and completing the forms below. Please be sure to bring them with you to your first visit. Completing the forms prior to your visit will help speed up the new patient registration process.

Appointment Cancellation Policy (PDF)

Authorization for Release of Medical Information (PDF) – Allows patients to authorize the disclosure of their health information to a designated individual, company, agency, or facility.

Authorization and Consent for Treatment (PDF) – All patients must provide their consent for treatment, communications (calls, emails, and text messaging), and agreement of financial responsibility.

Community Health Exchange (ENG) (PDF)

Community Health Exchange (ESP) (PDF)

Family and Friends Contact (PDF)

Medical History Information (PDF)

Medication History Consent (PDF)

Office Policies (PDF)

Preventive Medical Visit Patient Information (PDF) – Details financial responsibilities regarding preventive medical visits.

Preferred Contacts (PDF) – Patients are encouraged to complete and return the Preferred Contacts Form but it is not required.

Registration (PDF)

Pediatric Forms

Vanderbilt ADHD Diagnostic Parent Rating Scale (PDF)

Immunizations and Developmental Milestones for Your Child from Birth Through 6 Years Old (PDF)

Recommended Immunizations for Children from Birth Through 6 Years Old (PDF)

Well Child Schedule (PDF)

Modified Checklist for Autism in Toddlers, Revised with Follow-Up (PDF)

Office Policies

Financial Policy (PDF) - This form advises patients of their complete financial responsibility for all medical services received without regard to insurance eligibility or coverage determinations.

Notice of Privacy Practices (PDF) - Describes how health information about you (as a patient of this Care Center) may be used and disclosed, and how you can get access to your individually identifiable health information. Please review this notice carefully.

HIPAA Privacy Notice