Texas Ave.Medical Clinic
Dr. Rany Cherian, M.D.
Welcome to Texas Ave. Medical Clinic
As health care providers we ensure patient care
is equal for all of humanity to the best of our abilities.
Forms
For your convience and to save you time.
We have supplied
below our forms for you to print and complete.
Please bring these forms with you
to the clinic.
Patient Information
Patient Consent for Treatment, Payment, and Healthcare Operations
Acknowledge of Receipt of Privacy Notice
Notice of Privacy Practices
Financial Policy Agreement
Medical records release form and process
Please fill form out to its entirety
Legally we have up to 14 days to process records
Please mail, fax or drop the form by the office
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©Copyright 2008 - 2013, Dr. Rany Cherian, Texas Medical Clinic, Bryan, Texas All Rights Reserved
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