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    New Patient Forms

    REGISTRATION FORM_1 (pdf)

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    PAST MEDICAL HISTORY FORM_2 (pdf)

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    CURRENT MEDICATION AND SURGICAL HISTORY FORM_3 (pdf)

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    CONFIDENTIAL COMMUNICATIONS FORM_4 (pdf)

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    NOTICE OF PRIVACY PRACTICES FORM_5 (pdf)

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    INSURANCE CONSENT FORM_6 (pdf)

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    Dr. Ray W. Ng, DPM, PA and Associates

    112 North Adelaide Street, Terrell, Texas 75160, United States

    Phone (972) 524-3668 Fax (214) 602-36688

    Copyright © 2021 Dr. Ray W. Ng, and Associates - All Rights Reserved.

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    As Us About Smart-LEDA Plus

    19-21 Million Americans Have PAD


    2 out of 3 patients do not show signs or symptoms


    Learn more

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