Patient Forms
For your convenience, here are pdf versions of our new patient forms. You may print them out and fill them out in advance of your visit. Bring these with you to your visit or fax them to us at 713-464-2976. If you have questions, please call our office at 713-932-TOMI.
HIPAA Acknowledgement (For a copy of our HIPAA Policy, click here).
The Health Information Release form is required to have medical records released from TOMI or to have medical records sent to TOMI. If you are unable to submit this form in person to TOMI, you may mail it to 9225 Katy Fwy Ste 404 Houston Tx 77024 or fax it to 713-464-2976. If you have any questions regarding this form, please call 713-932-TOMI.