by Dr. Joel W. Brook
Dr. Joel Brook is a board-certified podiatrist and foot and ankle surgeon at Dallas Podiatry Works in TX.
“Welcome to Dallas Podiatry Works. My name is Zoraida, and my name is Ana and we are your patient care coordinators. Today we are going to be going over what you need to bring for your first appointment and the new patient documents.
What we ask for you to bring on your first appointment is your insurance card and some form of identification. Next we’ll go over the new patient forms. This first page is the patient demographic page. Please fill out the top with your basic information as well as your insurance and emergency contact information. We ask that you read the bottom paragraph and sign and date the bottom.
The next page is your medical history page. It is very important that you list all your medications. The next page is the review of systems page. Please go over each section and check the ones that apply to you. This next page is your patient financial policy. Be sure to read over every paragraph and sign and date.
The last page contains two pages. This is going to be the HIPAA disclosure form. This first page is where you will list your designated relatives or friends that you would like to disclose your health information to, as well as list your preferred method of contact. The last page, you will just go over each point and sign and date the bottom. If there are any issues or questions, feel free to give us a call.
Thank you for being our patient. We are honored to be part of your healthcare team!”