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 follow the instructions below:
Download, Complete the Form, Bring to Appointment OR Upload
Steps:
1) Download the forms by clicking ‘download’ under the Form tab,
2) Print out and complete forms,
3) Bring your completed forms to your appointment or upload them using the form below.
Patient Intake Forms
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 the form(s), 2) You have printed and completed the Patient Check-In form(s) by hand, 3) You have scanned and saved your completed form(s) in .PDF FILE FORMAT ONLY.
"*" 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.
Ivorry Gomez, DNP, FNP-BC, MPH
Learn More About Ivorry Gomez's Biography, Specialities, and Certifications
Ivorry Gomez is a dedicated and highly skilled Nurse Practitioner committed to delivering compassionate, evidence-based care.
Dallas
12606 Greenville Ave, #215
Dallas TX 75243
Hours: Tuesday 8:00 am-5:00 pm
Fri: 8:00 am-Noon
(214) 736-2445 office
(214) 736-2458 fax
Rockwall
Medical Arts Building
2504 Ridge Road, Suite 108
Rockwall, TX 75087
Hours: Mon-Thu 8:00 am-5:00 pm
Fri: 8:00 am-noon
(214) 736-2445 office
(214) 736-2458 fax