Please click here and complete the form before your first office visit. This will save you time and make the office administration process easier. You may print the answered questions if the form fails to submit. Please remember to fill out tabs: DEMOGRAPHICS, MEDICAL HISTORY, MEDICAL INSURANCE, and VISION PLAN before you click the gray submit data box in the submit data tab. If you do not have medical insurance and/or a vision plan, select none.
Existing Patients
Please call our office at (806) 796-5816 to schedule an appointment.
We will generate a pass code allowing you to verify and update your patient information. Please enter the pass code below and update your demographic information and all pertinent health information.
If you have any problems or questions please contact us at (806) 796-5816.