Patient Forms

As a courtesy to our patients, we’ve made available these helpful forms and information packets. Simply click on the links below to view each PDF.

Important: You must have an Adobe Acrobat Reader:

General Information

Payment Policy PAYMENT-POLICY

New Patient Packet (English) NEW-PATIENT-PACKET-ENGLISH

New Patient Packet (en Espanol) NEW-PATIENT-PACKET-ESPANOL

New Patient Packet (Florida) NEW_PATIENT_PACKET

Information Sharing INFORMATION-SHARING

Follow Up Packet FOLLOW-UP-PACKET

Authorization to Release Health Information

Latisse Consent Form

Photos and Videos

Taking Standardized Photos at Home Taking-Standardized-Photos-at-Home

TED Videos Instructions TED-Videos-Instructions

Accepted Insurance

Dr. Soparkar | Texas CNSS-Houston-Insurance

Dr. Patrinely | Florida JRP-Florida-Insurance

Dr. Patrinely | Texas JRP-Houston-Insurance