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Welcome to Your Patient Resources Page

Here you'll find all the necessary forms and helpful resources to make your visit with Dr. LeCroy as smooth and efficient as possible. Whether you need to download patient forms, access medical information, or prepare for your appointment, everything you need is right here.
NEW PATIENTS!
DOWNLOAD AND FILL OUT THE
FOLLOWING FORMS:

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Medical History Form:

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Demographics:

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State Immunization Form:

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Patient Consent Form:

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Cash Pay Options:

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INSTRUCTIONS ON TECHNICAL ISUES YOU MAY ENCOUNTER:

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Email Questions:

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Patient Portal Access:

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VARIOUS OTHER HELPFUL FORMS:

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HIPPAA Document:

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Automobilie Accident form:

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​FMLA request:

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Medical Record Release Request:

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Lighthouse Family Medicine

6424 Colleyville Blvd.

Suite 104

Colleyville, TX  76034

(817) 482-9422

(877) 738-7691 fax

For Life-Threatening Emergencies Call 911

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