Please complete the new patient form.

When you are finished, click Submit Form to return the completed form.

IN ACROBAT, THE BUTTONS BELOW CAN OPEN A FILE PICKER. REPEAT AS NEEDED.

IF UNAVAILABLE, PRINT AND HANDWRITTEN COPIES ARE OK.


ATTACH RECORDS, MEDICATION LIST, OTHER DOCUMENTS SUCH AS LAB RESULTS, DISCHARGE SUMMARIES, OR REFERRAL LETTERS. YOU MAY UPLOAD MULTIPLE FILES IF NEEDED.

How to send the forms back: please return them at least 24 hours before your visit.

• Patient Portal (PMD) message: PATIENT PORTAL HERE
• Email OFFICE@METROPOLITANID.COM
• EFax (713) 583-2339
  If NONE of that is possible, please bring them with you to your appointment.

Questions? Just call us at (713) 339-9949. We are happy to help you fill out the forms.

We look forward to seeing you! Se Habla Español

PLEASE BRING TO APPOINTMENTS

• Your photo ID and insurance card.
• Your pill bottles or a written list of your medicines if they have changed since you filled out your form.
• Any recent or related lab, X-ray, or hospital papers you have.

Metro ID | 7777 Southwest Freeway, (MED PLAZA #1) Suite #610 | Houston, TX 77074

Phone: (713) 339-9949 | EFax: (713) 583-2339

www.metropolitanid.com | OFFICE@METROPOLITANID.COM