Patient Forms

Please complete the following forms and bring them to your first appointment:

​

Patient Registration Form

​

Consent to Use PHI

​

Acknowledgement of Receipt of Patient Privacy Policy 

​

Patient Privacy Policy

​

​

​

​

​

DUE TO THE SENSITIVITIES OF MANY OF OUR PATIENTS, WE ARE A PERFUME-FREE CLINIC
Kimberly Jones, D.C.   
Concorde on the Creek
6750 Hillcrest Plaza Drive, Suite 222
Dallas, TX 75230                             
214-546-4321 (phone)

© 2021 by Kimberly Jones, DC