Welcome to Durbin Family Practice

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Our Mission is "To provide our patients and their families exceptional healthcare."

PATIENT FORMS


Thank you for selecting Durbin Family Practice for your healthcare needs. We strive to deliver comprehensive, high quality, cost-effective care with a focus on the quality of the Provider/Patient relationship and patient satisfaction.

To better serve you, we ask that you bring all of the following items to your appointment:

 

• Completed paper work
• Any recent x-ray or MRI results related to your condition
• Any recent tests related to your condition
• Driver's license
• List of all medications you are currently taking
• Insurance card
• Military ID (if applicable)
• Payment ( We accept American Express, Discover, Mastercard and Visa).


Should you have any questions or need to reschedule you appointment please call our office at (817) 640-5412. Thank you again for choosing Durbin Family Practice. We look forward to seeing you.

The following forms can be printed from your printer prior to your visit. Completing these forms will save time during your office visit.

 

Patient Information Sheet

Insurance Assignment & Release
Health History
Patient Record Of Disclosures
Notice Of Privacy Practices

 

    Visit    on:

319 Osler Drive, Suite 160  Arlington, Texas 76010   
 (817) 640-5412