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Please call 1-866-645-6455 or 214-645-6455 to learn more information about any of our physicians.

UT Southwestern Medical Center offers several forms online so that patients may print and complete them prior to their hospital stay or clinical practice visit.

Authorization to Disclose Protected Health Information (pdf)
Directive to Physicians and Family of Surrogates (en Español) (pdf)
Medical Power of Attorney (en Español) (pdf)
Out-of-Hospital Do-Not-Resuscitate (DNR) Order (pdf)

UT Southwestern Medical Center 5323 Harry Hines Blvd Dallas, Texas 75390 214-648-3111 Home Legal Policies State of Texas Texas Homeland Security Statewide Search

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Printable Patient Forms

Patients & Visitors

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