Patient Forms

For your convenience, common patient forms can be viewed or printed in advance of your visit.

Patient Registration Form

Patient Satisfaction Survey

Notice of Privacy Practices

Medical Records Release/Transfer

 

Medical Records

 

Patient records are held in a digital format and aggregated into an Electronic Health Record (EHR).

Electronic Health Records bring many benefits:

  • Secure and private
  • Accessible at all locations
  • Files unified for complete record
  • Environmentally sound

If you want to get a copy of your medical records fill out this form.

Transferring Records

Medical records can be transferred to Complete Surgery Houston Northwest by sending your current provider a completed authorization form. Use the Medical Records Release form found in the Patient Forms section.

Fax completed form to: 281-502-0002.

Please mail completed form to: 1900 North Loop West Suite 600, Houston, Texas 77018