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Privacy

Forms and Guidelines

Each new patient is required by federal law to review the privacy policy developed by each health care office. To avoid confusion, we have adopted a conventional, standardized version of this form, so that it should be similar to policies and forms in place at the practices of other doctors in Texas. Normally, new patients must receive, review, and sign a form on each visit to a different doctor.

For your convenience, we offer our version of the HIPAA privacy form online. By clicking on the icon below, you may print it from your computer and fill it out on paper before your visit. Then simply bring the signed last page (page 5) on your first visit, potentially saving your time.

Please click to display or download the form in a new page or tab.

HIPAA.pdf

Another frequently encountered issue covered by HIPAA involves transfer of medical records, either to us from another office or from us to an outside hospital or clinic. This form is provided here for you to download.

You may also verbally request for us to send records to your referring or other doctor from our office. Please note that many offices are unnecessarily strict and will not provide the same courtesy. In that case they will require you to request movement of records in writing. The fax number for Allergy, Asthma, and Immunology of North Texas is 469-519-0551. Records requests may also be emailed to info@allergynorthtexas.com, in accordance with our terms of use.

Please click to display or download the form in a new page or tab.

Transfer.pdf