Patient Forms

We have provided our New Patient forms that can be downloaded below.

To print the forms, you will need a PDF Reader like Adobe Acrobat Reader.

Medical Records Release Form

Obstetrix Packet (fill out only if referred to Obstetrix clinic in Ft. Worth)

Patient Registration

Obstetrix HIPAA Form

Financial Policy

OB Hx Questionaire

Authorization for Verbal Release

UltraSound Information

Acknowledgement Form Privacy Notice

Patient Education & Resources

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CDC Covid Recommendations

Precautions and protective measures from the CDC on Covid-19. For the latest information please refer to the CDC website

Dr. Bannon & Benac experience labor pains!

Check out the viral facebook live where Dr. Bannon and Dr. Benac got to experience labor pains!

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