To ensure that your visit to our office is as convenient and efficient as possible, we are pleased to offer our registration forms online. The patient registration form may be completed electronically and printed for better legibility or completed manually.

New Patient Registration Forms

• New patient packet
• New patient packet (español)
• Health history

Authorization Forms

We do not release your medical information without your authorization.

• Release of information (to HTPN)
• Release of information (from HTPN)

Other Forms

• Health history follow-up
• Health history follow-up (español)
• No show/cancellation policy
• Referral form
• Fee for form com​pletion

Whether you change insurance or keep your same plan, your coverage may have updates. Our guide can help you navigate those changes and prevent delays in your treatment.

Patient Insurance Guide

Your First Appointment

There are three sets of forms required for new patients listed below:

• Release of Information form—We need this form as soon as possible in order to request your medical records from other providers involved in your care. If our office does not receive this form in a timely manner, then our office will be unable to obtain medical records relating to your condition. In order for your appointment to run smoothly and in a timely manner we require having medical records prior to appointment. If we do not receive your release of information in a tim​ely manner we will, unfortunately, have to reschedule your appointment.
• Assessment form—The assessment is detailed, but it is so we can provide the best care to you. Please take your time filling this form out, and give us as much detail as you need to. Themistocles Dassopoulos, MD, requires that the health assessment is done prior to you coming in for your appointment. Dr. Dassopoulos will evaluate your history and present-day symptoms to prepare for your upcoming visit.
• Registration forms—You may bring these to your appointment.

Please fill these out completely. You can either fax or email your forms to the clinic. This helps reduce delays at your appointment time. Due to the complex nature of the specialty care that we provide, your appointment may take two to three hours from the time you check-in to the time you check out.

You can find all forms under the Patient Forms.

What to Bring with You

• Your insurance card and picture ID
• Any updated medical records
• CDs or X-rays that are related to your condition that have not already been sent
• Your medications

What We Need from You

• To inform the IBD staff of any pertinent changes in your contact information, other health issues, medications, primary and other physicians, insurance and employment.
• Arrive on time for scheduled appointments. Call the office as soon as you are aware you cannot make an appointment or are running late.
• Provide payment for services not covered by insurance within 90 days.
• Pay all co‐payments and/or previous balances at the time of check out.
• Follow the recommended treatment plan and inform care team of any changes.

Emergencies

For life‐threatening situations, call 911. If you have an urgent problem after hours, please call our office and you will be forwarded to our answering service. They will page the physician on-call.

Most inflammatory bowel disease (IBD) patients report benefits from restricting their diet during flares. However, restricting your diet can put you at an increased risk of dehydration and protein-calorie malnutrition. Most patients need more calories, but tend to restrict their diet to eat more foods to decrease stool output and have fewer symptoms . While this is a short term solution, it is important to know how to manage your symptoms during a flare while also getting adequate nutrition to prevent these potential risks.

The staff at the Baylor Scott & White Center for Inflammatory Bowel Diseases has more than 20 years of experience caring for patients with inflammatory bowel disease (IBD), like Crohn’s disease and ulcerative colitis, which require lifelong, coordinated care.

Transitioning from pediatric to adult care represents a critical process for children suffering from IBD. The Baylor Scott & White Center for Inflammatory Bowel Diseases works with young patients, their families, and pediatric GI specialists to create a smooth transition into the adult care setting.

Here is a collection of helpful resources for inflammatory bowel diseases.

MyBSWHealth is an online tool where you can communicate with your providers, schedule an appointment, access and manage your family’s health.

We offer an easy, secure way to pay your HTPN bill online through MyBSWHealth.

At Baylor Scott & White Health, we want to be a resource for you and your family. Our team of financial counselors is here to help. We encourage you to speak to a member of our team at any time – before, during or after care is received.

Baylor Scott & White has established agreements with several types of insurances in an effort to make sure your health needs are covered.