Southern Horizon Healthcare
📋 Patient Forms

Save time
before your visit.

Download, complete, and bring your forms to your appointment. Arriving prepared helps us serve you faster.

Home› Patient Forms
1
Submit Securely  Recommended
Click "Submit Securely" — complete and submit your form through our HIPAA-encrypted portal. Nothing to print or bring to your appointment.
2
Or fill & print
Click "Fill & Print" to open the form in your browser, fill it out, then print or save a copy to bring with you.
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Bring to your appointment
If printing, arrive 15 minutes early with your completed forms, ID, and insurance card.
4
Prefer paper?
Use "Download" to save the PDF and fill it by hand before your visit.

Downloadable PDFs

Patient forms

Choose how you'd like to complete your forms: submit securely online through our HIPAA-encrypted portal, fill in your browser and print, or download to complete by hand.

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HIPAA Secure
Secure online submission available
Click "Submit Securely" on any form to complete and submit it online through Adobe Acrobat Sign — our HIPAA-compliant, end-to-end encrypted signing platform. Your information is fully protected and never transmitted via regular email. No printing or bringing paperwork to your appointment required.
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New Patient Paperwork

Complete this form if you are a first-time patient at Southern Horizon Healthcare. Includes personal information, insurance details, medical history, current medications, allergies, and consent to treat.

Submit Securely
Download
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Routine Physical Exam

Required for annual wellness exams and routine physicals. Covers your current health status, past medical and surgical history, family history, social history, and a full review of systems.

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Download
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Notice of Privacy Practice

Acknowledges that you have received and reviewed our HIPAA Notice of Privacy Practices, which describes how your medical information may be used and disclosed. Required for all patients.

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Download
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Record Release Form

Authorizes Southern Horizon Healthcare to release your medical records to another provider, facility, or yourself. Required for all medical records transfers. Specify the recipient and date range of records.

Submit Securely
Download
Submitting securely? Click "Submit Securely" on any form to complete it online through our HIPAA-encrypted portal — no printing required.  |  Need help? Call 469-645-0200 or email info@southernhorizon.org and we'll be happy to assist.

Ready to book your appointment?

Forms ready? Schedule your visit with our team in Highland Village, TX.

🔒 Secure online submission is coming soon. In the meantime, please use "Fill & Print" or download your form and bring it completed to your appointment.