Patient Forms

Download these forms in PDF format

Patient Forms

These forms are in PDF format (.pdf). Please download and install the latest version of Adobe Reader if you cannot open the files.

Click on a link below to open a printable PDF document file:

Patient Information

Notice of Privacy Practices and Patient Consent For Use and Disclosure of Protected Health Information

Authorization Form For Release of Protected Health Information

Completed forms can be faxed or mailed to:

Weslaco Family Care Center
909 S Airport Dr,
Weslaco, TX 78596
Fax: 956-969-0014

Use the form below to request medical records and release of medical records.