Save time by filling out forms before you arrive.

Please read the description below for each form. Each form can be printed for completion.

New Patient Specialty Intake Form
This form is required for registration when you arrive for your first visit at Baylor Family Medicine. It contains questions specific to our specialty. Please bring your completed New Patient Specialty Intake Form to the office on the day of your first appointment. If you have any questions regarding this form, please call 713.798.7700.

NOTE: If you are new to Baylor College of Medicine and have not been seen in any of our offices, please be sure to also complete our New Patient General Intake Questionnaire before your visit. This questionnaire is available at our office or online through our interactive web site, MyChart.

Authorization for Release of Protected Health Information (English) (Spanish)
This form is required to have medical records released from BFM or to have medical records sent to BFM. If you are unable to submit this form in person to BFM, you may mail it to BFM or you can fax it to 713.798.7775. If you have any questions regarding this form, please call 713.798.7460.

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Phone: 713.798.7700 Fax: 713.798.7775
Last Modified: May 13, 2013