Forms - Lone Star Neurology

Patient Forms

-If you are a New Patient, please print or use our fillable form for the new patient paperwork.

-If you plan on doing any appointments virtually you will also need to fill the telemedicine consent form.

-if you are seeing us for an accident-related injury, you will need to complete our Injury Form.

Important: please make sure to press SUBMIT when filling online forms so that it gets sent to our office.

Fillable New Patient Form

Printable New Patient Form

To authorize a new facility to send us your medical records, please fill out the Medical Records Release Form

Fillable Medical Records Release

Printable Medical Records Release

If you would like to release your records or health information to a family member, guardian, or caretaker please fill out the Release of Medical Information.

Fillable Release of Medical Information

Printable Release of Medical Information

Fillable Tele consent

Printable Tele consent

Fillable Injury Form

Printable Injury Form

If you are a provider looking to refer a patient over to our office. Please see our Neuro Order Form with options for testing such as EEG, EMG, Imaging, and IV Infusion.

Fillable Neuro order Form

Physicians Forms

Patient referral: you may fax a referral to us at (214)619-1913
or you can call our office at (214) 619-1910.

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