(817) 576-6765
Arlington, TX 76012

Online Forms

Online patient forms at Access to Health
Preferred Method

Complete Your Forms Before Your Visit

The online intake is preferred, but we understand sometimes computers don't do what we want them to. Save time at your appointment by completing your forms in advance.

Important: Please complete the online form on a laptop or desktop computer. The form will not transmit when completed on a mobile device.
Complete Online Form

Tips for Completing Online Forms

Adobe Reader Required

If you don't have Adobe Reader® installed, you'll need to download it first.

Download Adobe Reader

Skip Inapplicable Fields

You don't need to complete every entry. If something doesn't apply, simply skip it and go to the next question.

Submit After Signing

Sign your name using your mouse, click "submit" and the data will be securely transferred to our system.

Note: After signing, it may say "fields are incomplete", but it will transmit okay!

Alternative Options

If you're unable to complete the online version, or prefer paper, here are your options:

Print & Fax

Print the appropriate form and fax it to us at (970) 206-4871

Bring to Appointment

Print and bring the completed form to your appointment

Complete in Office

Come 15 minutes early to fill out the intake form at our office

Downloadable Forms

Auto Accident Form

Use this instead of online form

If you were in an auto accident, please print this form and bring it to your visit instead of completing the online intake form.

Download Auto Accident Form

Patient Privacy Policy

Review our HIPAA privacy policy and consent information

Download Privacy Policy

Need Help with Forms?

If you have any questions about completing your forms or need assistance, please don't hesitate to contact our office.