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Impact Health Direct Primary Care, PLLC
  • Home/
  • About Us/
    • Our Team
    • Our Practice
    • About DPC
  • Member Benefits/
  • Pricing/
  • Aesthetics/
    • Services
    • DiamondGlow®
    • Micro-needling
    • Aesthetics Membership
  • Weight Loss/
  • Other Services/
    • Personalized Testing
    • Pre-operative Evaluation
  • FAQ/
  • Employers/
  • Schedule/
  • Contact/
  • Enroll/
Impact Health Direct Primary Care, PLLC

Ennis, Texas Family Medicine Practice

Forms

Impact Health Direct Primary Care, PLLC
  • Home/
  • About Us/
    • Our Team
    • Our Practice
    • About DPC
  • Member Benefits/
  • Pricing/
  • Aesthetics/
    • Services
    • DiamondGlow®
    • Micro-needling
    • Aesthetics Membership
  • Weight Loss/
  • Other Services/
    • Personalized Testing
    • Pre-operative Evaluation
  • FAQ/
  • Employers/
  • Schedule/
  • Contact/
  • Enroll/

Forms

New Patient Forms

New Direct Primary Care Patient Forms

New Medicare Patient Forms

Notice of Privacy Practices

Consent to Treat

Visit Specific Questionnaires

Annual Medicare Wellness

Well Woman Exam

Questionnaires and In-Office Forms

GAD-7

MDQ

PHQ-9

Sleep Apnea Screening

Triage Forms

Acute Illness/URI

Back pain

Conjunctivitis

Gastrointestinal Triage

Musculoskeletal Triage

Pain

Rash

Sore Throat

Urinary Tract Infection

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Contact us

Phone (972) 846-4800

Fax (972) 947-5257

Email info@impacthealthdpc.com

Ennis Address 711 W. Lampasas, Ennis, TX 75119

Hours by appointment only

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