New Patient Information Forms
Drs. Curtis and Sylvia Gleaton are always accepting new patients. We are excited that you have decided to become a new patient!
Click here to
scheduled an appointment
or contact our office at 817-461-5455.
After scheduling an appointment, click on the two links provided below required for all patients to fill out prior to appointments. The information on these forms is strictly confidential and will be used only by our Drs. and staff to better serve you.
If you have any questions or concerns, please don’t hesitate to contact our office.
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Patient Registration and Medical History Form
Please fill in and sign
both forms.
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This is a large form (2MB). Please allow time for it to load based on your
connection. Fill out the form online if you wish then print. Bring the printed
form to your appointment.
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Patient Insurance and HIPAA-Privacy Form
Please fill in the
insurance form and initial the Privacy form.
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This is a large form (2MB). Please allow time for it to load based on your
connection. Fill out the form online if you wish then print. Bring the printed
form to your appointment.
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