Patient Check-In Forms
Our goal is to better serve you and improve your health! By completing the check-in forms ahead of time, you’ll save time in your appointment AND allow us to have the most accurate information. Please choose from one of the two options below and follow the instructions:
[ Please advise as to the most efficient procedures based on your office – fairly complex instructions right now ]
1. EASIEST METHOD - ONLINE:
Complete & Send Online (Valid email Required)
Steps:
1) Launch the respective form by clicking ‘online’ under the Form tab at top of page,
2) Complete electronically on your computer and follow the prompts,
3) Check your email to approve and send to DECCT.
2. ALTERNATE METHOD:
Download, Complete the Form, Scan/Save & Upload
Steps:
1) Download the forms by clicking ‘download’ under the Form tab below,
2) Print out and complete form,
3) Scan, save to your computer, and upload with the tool below.
ALTERNATE METHOD:
Download / Complete / Upload, or Bring With You
Step 1: Download, print out, complete by hand,
Step 2: Scan to a PDF file, save to your computer, upload using the tool below
Patient Check-In Upload Tool
All patient information will be uploaded in an encrypted data format for security and confidentiality purposes. You may use this upload tool AFTER: 1) You have downloaded/completed on your computer and saved to pdf format OR, 2) You downloaded, printed and completed the Patient Check-In forms by hand and scanned the handwritten forms into a pdf format.
"*" indicates required fields
SENDING & REQUESTING INFORMATION
In a doctor/patient relationship, there may be more information that we need to obtain. Click on this resource list to send us Outside Lab Results, Imaging from other Providers, Medical Records from other Providers, or your personal blood sugar logs. Files must be in PDF, .doc, or .txt file formats.
Click Here to Send Us:
Trusted by Patients
Dr. Carlos Arauz Pacheco, MD
Learn More About Dr. Arauz-Pacheco's Biography, Specialities, and Certifications
Dr. Carlos Arauz-Pacheco, MD is an Endocrinologist who has practiced in the Dallas area since 1994. He has expertise in several areas such as Diabetes Mellitus, Type 1 and Type 2, Hyperlipidemia, Obesity, diseases of the Thyroid Gland, Adrenal Glands and Pituitary Gland, Polycystic Ovary Syndrome, Parathyroid Disease, and Osteoporosis. He has ample experience in the management of Insulin Pumps, Thyroid Ultrasound, Thyroid Biopsies, among others.
Dr. Dan Lender, MD
Learn More About Dr. Lender's Biography, Specialities, and Certifications
Dr. Dan Lender, MD is a Endocrinology, Diabetes & Metabolism Specialist in Rockwall, Texas with over 35 years of experience in the medical field.
Learn More About Pauline Pagel's Biography, Specialities, and Certifications
Polly has been a Registered Nurse for 30 years with experience in Emergency Room Nursing and Intensive Care Nursing at Parkland Hospital in Dallas.
Dallas
12606 Greenville Ave, #215
Dallas TX 75243
Hours: Mon-Thu 8:00 am-5:00 pm
Fri: 8:00 am-Noon
(214) 257-7721
(972) 475-5668 fax
Rockwall
890 Rockwall Pkwy, #102
Rockwall TX 75032
Hours: Mon-Thu 8:00 am-5:00 pm
Fri: 8:00 am-noon
(972) 475-5600
(972) 475-5668 fax