New Patient Information

Thank you for choosing Doc D Consulting. Our practice offers a full range of medical services, all provided with compassionate, friendly care. We ask that you fill out, print and bring in the relevant forms for your first visit.

If you have any questions or concerns before your appointment, please contact us

It is required you bring to your appointment:

All completed paperwork
Driver license or Government issued ID
Insurance Information
Possibly a referral from your primary care doctor if you have an HMO or Medicare

The following form is in PDF format. You can use Sejda.com to complete the form online (no registration needed) and either print at home to bring to your appointment or save and email us the form. Please remember to sign and date both the HIPPA and Consent forms.

New Patient Form

Dr. Dombroski’s goal is to work in tandem with a patient’s existing specialists and/or primary care doctor to provide additional treatment options that give each patient the ultimate care they deserve.

Our Office Location:

6913 Camp Bowie Blvd,

Suite #107
Fort Worth, TX 76116