Make an Appointment
...if you are a new patient for Dr. Slawin, contact Edna Escamilla, directly by...
...or if you are a new patient for Dr. Shu, contact Carrie Hughes, L.V.N., directly by...
...or if you are a new patient for Dr. Hinh, contact Paola Maldonado, directly by...
...if you are a new patient for John Dodge, PA-C, contact Edna Escamilla directly by...
New Patient Information Packet
If this is your first time to see us in our new facility, please:
- Print the following forms on standard white 8.5" x 11" paper.
- Fill them out completely.
- Bring the completed forms with you to the clinic on the day of your appointment, or fax them to 713-366-7981, ATTN: Appointment Desk, several days before your appointment.
Patient Information Forms
- (Please be advised that the majority of our Patient forms are to be signed electronically at our Kiosk the first time you check in. In addition, please bring your Driver's License or State ID along with all of your insurance cards as they will be scanned at the Kiosk the first time you check in as well.)
- Medical History Questionnaire – Please download, print, and fill out completely.
- Release Form – Please download, print, fill out, and sign in ink to request to have your Medical Records transferred from another Physician's office. Please be sure to write in the fax number for the other Physician's office so that we can submit the request electronically.
Click here for office addresses, maps and driving directions.
back to top