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Patient Forms

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

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Patient Registration Form

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Consent to Use PHI

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Acknowledgement of Receipt of Patient Privacy Policy 

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Patient Privacy Policy

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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

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