For your convenience, we have made several forms available to you through our web site. Simply download and print the necessary documents below, fill them out at your convenience and bring them with you on your next visit.
New Patient Form
Patient History
Consent for Treatment
Consent to Communicate
Financial Policy
HIPAA Notice
Authorization to Release
Epworth Sleepness Scale
Health Risk Assessment for Medicare Annual Wellness Visit
Checklist for Your Annual Medicare Wellness Visit
ABA publishes the Machine-Readable Files on behalf of Family Medical Group of Texarkana
To link to the Machine-Readable Files, please click on the URL provided: transparency.abadmin.com
Change Health Care Security Breach Information Notice: https://www.changehealthcare.com/hipaa-substitute-notice
2101 Galleria Oaks Drive Texarkana, TX 75503
Phone:
(903) 791-9120
Busines s Hours:
Monday to Friday: 8am-5pm
5212 West 7th Street Wake Village, TX 75501
4105 N. Kings Hwy Texarkana, TX 75503
Phone:
(903) 838-0444
Fax: (903) 334-7618
Monday – Friday 8:00 am – 5:00 pm