OFFICE HOURS: (with appointments daily)
Monday – Thursday 8:00am to 5:00p, Friday 8:00am to 12:00pm
Below you will find our forms available for download. You will need Adobe Reader in order to view these forms. After completing the forms, you can email them to media@holinergroup.com or text forms to 972-566-4591. Please note the text feature is for registration forms, Insurance Cards and ID’s only. If you have other concerns or issues you must call us at 972-566-4591.
Forms:
New Patient Forms – English
New Patient Forms – Español
New Patient Forms – Scott Thornton ONLY
New Patient Forms – Camille Holiner ONLY
Opioid Partial Agonists Contract – English
Opioid Partial Agonist Office FAQ’s
Patient Health Questionnaire
Patient Release Forms
Verbal Authorization Form
Verbal Authorization Form (Español)
Medical Release Form
Medical Release Form (Español)
Scott Thornton Medical Release Form
Camille Holiner Medical Release
Camille Holiner Credit Card Authorization
Patient Handouts/Resources:
Medication Side Effects Information
New Patient Handout- What to Bring and Expect
Bibliotherapy and Self Help books (all topics and categories)
Eating Disorder Resources
Electroconvulsive Therapy Resources
Internet Resources (all topics and categories)
Office Policies:
Billing Policy
Prescription Policy
Red Flag Policy
Below is a list of insurance companies we currently accept.
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** Please be advised that if your insurance plan is not listed above you may call our office (Dallas: 972-566-4591) to verify that it is an accepted plan as the list may change periodically.