Patient Resources
New Patient Registration Form-English
Nuevo registro de pacientes- Espanol
Privacy policy:
Personal information collected upon registration is name, insurance policy information. Email, Address and phone number. All information is stored on the EHR and is HIPPA compliant for security
Personal information is used for the treatment of medical related conditions
Personal information is shared with your insurance policy and referring provider.
- SMS consent is not shared with third parties, for example: "SMS consent is not shared with third parties for marketing purposes."
- Privacy policy is easily accessible via patient web portal and prominently included upon registration to the clinic.
By opting into SMS from a web form or other medium, you are agreeing to receive SMS messages from North Texas Foot & Ankle. This includes SMS messages for appointment scheduling, appointment reminders, post-visit instructions, lab notifications, and billing notifications. Message frequency varies. Message and data rates may apply. See privacy policy at https://practice.patientpop.com/contents/patient-resources/new-patient-documents. Message HELP for help. Reply STOP to any message to opt out.
