551 North Plano RD.
Richardson, TX 75081
PHONE: 972-669-8400
FAX: 972-235-0033
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M-W-F: 8AM - 5PM
TUE: 7AM - 3PM
THU: 8AM - 6PM
SAT: Every 2nd & 4th; 11AM-3PM
SUN: - Closed
HABLAMOS ESPANOL: M-F
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Childrens' Urgent Care Centers.
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regarding our terms
and policies.
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You may fill out, print, and submit the following forms online using a secure network:
Patient Registration Form
Adult Health History Questionnaire
Pediatric Health History Questionnaire
Please print, fill out, and submit the following forms to the receptionist upon your office visit:
Acknowledgement of Receipt of Notice of Privacy Practices for Review
Financial Policy
Other:
HIPAA Notice of Privacy Practice Number
Copyright 2007. Clinic for Family Health & Wellness. All rights reserved