New Patient Application

Thank you for your interest in our services. 

In order to streamline your first appointment, we ask that you fill in a New Patient Application prior to your visit. 

If you are a Medicare patient, then please contact us by telephone at 281-286-2229 for special instructions before proceeding. 

Thank you. 

        - Dr. Vazquez

Please click your preferred option to get started.  

AutoSave prevents accidental data loss, but requires a wait time each minute for saving data. 
Also, AutoSave options store data locally, so this is not recommended for use on a public device.

Offline Forms

If you would rather complete the forms offline, then please click the button below: