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Primary Location

4501 McCullough, Suite 107

San Antonio, TX 78212 US

210-828-9211

New Patient Online Forms

LET"S GET STARTED!  Schedule Your Consultation & Evaluation at #210-828-9211

Below are several forms we need from you for your first visit. 

Our New Patient Intake Form is an Adobe Interactive Form.  Please fill each form out and sign your name where applicable using the Fill & Sign tab on the upper right of the form.  Save your forms and email them to us at admin@ahchc.com before your arrival. 

These forms are required to be completed in order for you to be seen in our clinic. IF YOU ARE UNABLE TO DOWNLOAD AND COMPLETE YOUR INTAKE FORMS PRIOR TO YOUR SCHEDULED APPOINTMENT, YOU MUST ARRIVE AT LEAST 20 MINUTES EARLY - OR - YOUR APPOINTMENT MAY HAVE TO BE RESCHEDULED.

We are excited to meet you and help you begin your journey to wellness!

  • If you do not already have AdobeReader® installed on your computer, Click Here to download.
  • Download the necessary forms, print them out, and fill in the required information.
  • Please either fax us your printed and completed forms, or bring them with you to your appointment.

*Adult New Patient Health History Forms

*Pregnancy New Patient Health History Forms

*Pediatric Infants & Toddlers Health History Forms

*Pediatric School Aged Children Health History Forms

* Authorization for Treatment

* HIPAA Agreement: Explains the Health Insurance Portability & Accountability Act.  PDF Version

* Electronic Health Records Form


Download the Free AdobeReader®

CONTACT US TODAY

We look forward to hearing from you

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Office Hours

Our Regular Schedule

San Antonio Office

Monday:

7:30 am-11:00 am

1:30 pm-5:00 pm

Tuesday:

6:30 am-7:30 am

10:00 am-12:00 pm

Wednesday:

7:30 am-11:00 am

1:30 pm-5:00 pm

Thursday:

7:30 am-11:00 am

1:30 pm-5:00 pm

Friday:

7:30 am-11:00 am

Saturday:

1st Sat Only

9:00 am-11:00 am

Sunday:

Closed