Please print and fill out the new information packet below. You can fax (903-593-4303), email (firstname.lastname@example.org) mail or drop off your paperwork at our office. Note that if you email your paperwork, we can not guarantee it meets the standards for HIPAA.
If you are being seen for memory loss or dementia, please fill out this paperwork.
If you are being seen for headaches, please fill out this paperwork.
If you are being seen for seizures, spells or blackouts, please fill out this paperwork.
If you are being seen for any other neurological problems, please fill out this paperwork.
Authorization to Disclose Protected Health Information (Requesting Records from NETNA)
Nurse Practitioners and Resident Physician Information
Through our Electronic Health Record, our patients can view their own medical records. In addition, our patients can securely send messages to their physician or nurse practitioner as well as the NETNA staff. If you do not have access to the portal, please contact our office.