Patient Forms

Thank you for choosing Health Services of North Texas for your medical and wellness needs. We accept Medicare, Medicaid, CHIP and most Major Medical Insurance and offer a sliding fee scale to those patients who qualify.

We want your first visit to be a positive experience! Please take the time to complete your patient paperwork 24 hours before your scheduled appointment. You will love the results!

We realize there are some questions that seem unnecessary but due to demographic reporting requirements we have to ask. Thank you for understanding.

Complete all five steps for the best results!

We are only a phone call away if you need any help… 940-381-1501.

Our staff is looking forward to serving you!

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                                                                                pediatric form spanish
step 2 buttonarrowAdult Medical History Buttonadult-medical-history-spanish
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Thank you for taking the time to fill out the forms!

Insurance Accepted

The following commercial insurance plans are accepted at HSNT and we are working daily to add additional insurance carriers. Please check back often to see if yours has been added.

Blue Cross Blue Shield
United Health Care
Aetna
Cigna
Humana
Tricare
Denton County Indigent
Group and Pension Administrators (GPA)
Medicaid
Medicare
CHIP

*Medicare cards are changing! See what is changing and what the new cards look like here.

Health Information Exchange (HIE). Health Services of North Texas participates in electronic health exchanges and may share your health information as a means to improve the efficiency and effectiveness of our health care system. Participation is voluntary and will not affect your access to medical care. You may choose to opt out to the electronic health information exchanges by requesting our OPT-OUT form from your provider or our staff.