Administrative Forms for The Craniofacial Team of Texas (CTOT):
Please be sure to bring all completed forms with you to your appointment. Additional forms may need to be completed upon arrival.
New Patient Registration Packet CTOT – PDF Download
Our new patient packet contains:
- Patient Information General Consents & Acknowledgements
- HIPAA & Office Protocol
- Medical Records Release for Insurance
- Authorization for the Release of Medical Photographs/Slides and or Videotapes
- Authorization for Release of Protected Health Information To: Craniofacial Team of Texas
- Permission to Treat a Minor/Consent for Care
Speech Case History – PDF Download
Referral Request Form for Providers
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