New Patient Information and Forms



We are glad you have chosen Dr. Lewis Cummings! As part of your first visit with us, you will fill out a comprehensive medical and dental history. These forms are important because they help us to determine the course of your treatment.

For your convenience, you may print and fill out the below forms and bring them to our office upon your initial office visit or you may fax them to 281-358-6062. We look forward to seeing you. We encourage questions and do our best to always deliver quality care.



In order to view or print these forms you will need Adobe Acrobat Reader installed. Click here to download it.

 

PATIENT INFORMATION FORM

HEALTH QUESTIONNAIRE

FINANCIAL ARRANGEMENTS

NOTICE OF PRIVACY PRACTICES FOR PROTECTED HEALTH INFORMATION