At AccelHealth, we strive to make your relationship with us a convenient as possible. On this page, you will find multiple methods to get the forms that are necessary for us to provide the outstanding, whole family, healthcare you expect and deserve.


The preferred, and most efficient forms submission is with our on-line version listed first. With this method, forms are filled, signed, and submitted, all without requiring the forms to be printed, filled out, and carried to your clinic of choice.

AccelHealth has done extensive testing of the on-line forms, using multiple operating systems (PC, MAC, iPhone (iOS), and Android), with the browsers that come with the above listed systems. If for any reason you have problems filling out and submitting the forms, please follow this link and provide feedback detailing the issue, and we will do our best to address the problem.

In the event your system has problems with the on-line version, we provide links to download the forms. The downloaded forms will then need to be printed, filled out, and presented to the front desk when you arrive for your appointment. The forms would then be scanned into our system.

Required forms:(*) New Patient Registration, Family Size and Household Income, and HIPAA/PHI Authorization Form. Other listed forms are only required if additional assistance is requested. This applies to both the online and downloadable versions.

New Patient Forms (On-Line)

*New Patient Registration*Registro de nuevos pacientes
*Family Size and Household Income*Tamaño de la familia e ingresos familiares
*Consent To Treatment*Consentimiento al tratamiento
*HIPAA/PHI Authorization Form*Formulario de autorización de HIPAA / PHI
Notice of Privacy PracticeAviso de práctica de privacidad
Screening QuestionsPreguntas de detección
Letter of Support for Individuals with no incomeCarta de apoyo para personas sin ingresos
Application for Sliding FeeSolicitud de tarifa móvil

New Patient Forms (Download)

*New Patient-Registration* Nuevo registro de pacientes
*Family-Size-Household-Income* Tamaño de la familia-Ingresos del hogar
*HIPPA-PHI-Authorization-Form* Formulario de autorización de HIPAA-PHI
*Consent To Treatment*Consentimiento al Tratamiento
Letter-of-Support-FormFormulario de carta de apoyo
Sliding-Fee-ApplicationSolicitud de tarifa variable

AccelHealth Dental provides a “Dental Appointment Availability Form“, which allows our dental clinic to collect information on your availability to be called in an event of cancellations, thereby, allowing your regularly scheduled appointment to be moved to the newly created slot.

Dental Patient Forms (On-line)

Dental Appointment Availability QuestionnaireCuestionario de Disponibilidad de Cita Dental
COVID-19 Emergency Dental Treatment Consent FormForma De Consentimiento Para Tratamiento Dental De Emergencia COVID-19
Dental Health History QuestionnaireCuestionario de Historia de Salud Dental

Dental Patient Forms (Download)

COVID-19 Emergency Dental Consent Form, TXFormulario de consentimiento de emergencia dental COVID-19, TX
Health-HistoryHistoria de salud