Patient Forms


Authorization for Release of Medical Information:


Male Patient Intake Forms:

 

Female Patient Intake Forms:

  

Child Patient Intake Forms:

General Clinic Forms:

 

Intake Forms - Español:

  

 

The forms listed above are in PDF format and can be downloaded to your computer, printed and completed in the comfort of your home before your first visit to our clinic. Please be prepared to provide this information to our clinic along with your current insurance information. If you have any questions when filling out these forms, please do the best you can and our staff will assist you with your questions on the day of your visit.

Need Adobe Acrobat Reader?

If you do not have a copy of Acrobat Reader you can get one for free by clicking on the icon 'Get Acrobat® Reader'. This will take you to Adobe's website and enable you to download the Acrobat program to your computer.imgres

Resources

• American Cancer Society
 
• Getterman Wellness Center Cardiac and Pulmonary rehab
 
• Klaras Children’s Center ECI (Early Childhood Intervention)
 
• Susan G. Koman Breast Cancer Foundation
 
• Waco-McLennan County Public Health District
© 2016 Hillcrest Clinics. All Rights Reserved. | Privacy Statement
If you have a concern regarding the quality of care you received during your treatment at any one of the Hillcrest Clinics, or simply want to discuss an experience you may have had, please call our dedicated Patient Relations phone number at (254) 202-9680 Monday through Friday 8:00am-5:00pm.

To register a complaint about any provider or clinic with the Texas Medical Board, please click on the following link: Texas Medical Board.

The Hillcrest Clinics Websites are wholly owned and operated by HFHC (Hillcrest Family Health Centers). The websites, email your doctor, and the Hillcrest Clinics Patient Portal are for NON-EMERGENCY USE ONLY. Please allow up to 48 hours for a reply when using “Email Your Doctor” or the “Hillcrest Clinics Patient Portal”.
If you are experiencing an emergency, please call 9-1-1 or go to your nearest emergency room.