Patient Forms

The staff of A Bright Futures Pediatrics in Plano, Texas looks forward to having you and your child join our host of satisfied patients. To schedule an appointment, please call us at (972) 208-8668.

Once you have scheduled your child’s appointment, you can pre-register by downloading the new patient forms and HIPAA forms below and bringing them with you to your visit. Completing the forms prior to your visit will help speed up the new patient registration process.

Download new patient forms:

• New Patient Forms
• HIPAA Privacy Notice
• Incoming Medical Records Release

Download other forms:

• Outgoing Medical Records Release
• Authorization to Treat a Minor
• Office Policies
• Updated Information Form 

Please note: It may take a few minutes to load the forms if you are using a dial-up Internet connection. If you are unable to view the forms, you may need to download Adobe Acrobat Reader for free by clicking on the icon below.

Disclaimer: If you register, make an appointment or submit any other information online, all your information is transmitted securely and is held in strictest confidence, adhering to HIPAA guidelines and protecting your privacy.