ONLINE REGISTRATION FOR HECTOR L. FRANCO, M.D.
| 915-598-1959 |
| DERMATOLOGY |
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ATTENTION NEW OR UNESTABLISHED PATIENTS:
PLEASE DOWNLOAD THE ONLINE REGISTRATION PACKET ON THIS
SITE. THIS WILL ALLOW US TO GIVE YOU THE EARLIEST AVAILABLE
APPOINTMENT. THE NECESSARY PAGES CAN BE ACCESSED BY
CLICKING THE NAVIGATION BUTTONS AT LEFT. THEY INCLUDE:
1. MEDICAL HISTORY
2. INSURANCE
3. CONSENT FORM
4. HIPPA NOTIFICATION
5. COSMETIC INFO (optional)
BY COMPLETING THESE FORMS PRIOR TO YOUR VISIT YOU WILL
HELP US MAKE YOUR OFFICE EXPERIENCE MORE EFFICIENT.
BESIDES BRINGING YOUR COMPLETED REGISTRATION FORMS BE
SURE TO BRING A LIST OF CURRENT MEDICATIONS, ANY REFERRAL
FORMS AND PROOF OF INSURANCE. THANK YOU.
HECTOR L. FRANCO, M.D.
PLEASE DOWNLOAD THE ONLINE REGISTRATION PACKET ON THIS
SITE. THIS WILL ALLOW US TO GIVE YOU THE EARLIEST AVAILABLE
APPOINTMENT. THE NECESSARY PAGES CAN BE ACCESSED BY
CLICKING THE NAVIGATION BUTTONS AT LEFT. THEY INCLUDE:
1. MEDICAL HISTORY
2. INSURANCE
3. CONSENT FORM
4. HIPPA NOTIFICATION
5. COSMETIC INFO (optional)
BY COMPLETING THESE FORMS PRIOR TO YOUR VISIT YOU WILL
HELP US MAKE YOUR OFFICE EXPERIENCE MORE EFFICIENT.
BESIDES BRINGING YOUR COMPLETED REGISTRATION FORMS BE
SURE TO BRING A LIST OF CURRENT MEDICATIONS, ANY REFERRAL
FORMS AND PROOF OF INSURANCE. THANK YOU.
HECTOR L. FRANCO, M.D.