New Patient Forms
Please complete the New Patient Packet prior to your first appointment by accessing the Health Services web portal, mavcare.uta.edu, and clicking on the Forms link.
Or you can print the packet, complete, and bring to your appointment.
Medical Release Forms
- Authorization for Use and Disclosure of Protected Health Information (for requesting medical records for yourself)
- Authorization for Use and Disclosure of Protected Health Information to Outside Entity (for requesting medical records to release to someone else. e.g. doctor)
Your Rights and Responsibilities
Please print and read the following forms for your own information regarding your rights and responsibilities.
Health Services follows applicable State Medical Privacy Laws, including:
For questions regarding your medical records please contact the Administration Office at 817-272-2771.