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For scheduling
please call
(972) 566-6444

7777 Forest Lane (map)
Building B, Suite 424
Dallas, TX 75230

What Forms Might I Need?

The list that follows is presented here in order to assist you to relate efficiently with our office. In the event that you have questions, concerns or difficulties, please contact our office for assistance.

DO NOT FORWARD ANY PRIVATE INFORMATION THROUGH THIS WEBSITE. YOU MAY DOWNLOAD THE DOCUMENTS AND EITHER FORWARD THEM VIA FAX OR BRING OR MAIL THEM TO THE OFFICE.

Patient Privacy Policy Patient Privacy is a very important issue. Please consult our policy in the pdf download.
Patient Demographic and Insurance Form This document with its information is necessary to help us be accurate in maintaining your medical records throughout our relationship with you.
Patient History Form (PDF file, 46k) This form will help us to understand your past medical history including all the hospitalizations and operations that you may have had. It is imperative that we understand your current medications as well as your medication allergies. Your family history may have direct bearing on your health in manners that may not be apparent to you at this time.
Model Release (PDF file, 25k) We hold all of your health care information in strict confidence. Many of our operations involve very advanced technology and procedures. We are involved in the development of some of these technologies as well as teaching at the post-graduate level. We frequently photograph and "video" parts of our operations for these educational purposes. The patient is not identifiable in these photographs and/or videos. In the event that you have questions concerning this, please feel free to discuss it with us.
Welcome To Our Office (PDF file, 24k) This form (to be signed by the patient in our office at the time of the initial consultation) acknowledges that some fundamental information has been provided to them.
Patient Consent Form (PDF file, 42k)
Patient Information Form (PDF file, 68k)

HOSPITAL FORMS

There are some forms that may be important for you to consider prior to your admission to hospital.

Advance Directive This form instructs your physician and health care team regarding your specific wishes about your health care and your life. Please read it carefully. It is vitally important to you, your family and your health care team.
Power of Attorney This form identifies the individual to whom you give the power to make decisions regarding your health care in the unlikely event that you are incapable of making those critical decisions.


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This page last edited on 2/19

All content ©2016 by Neurosurgical Consultants, P.A.
Author, Martin L. Lazar, MD, FACS
All Rights Reserved. See Usage Notices.