Medical Records Release from us to another provider

Healthcare Directives

Influenza Vaccine (VIS) - What You Need to Know (CDC) 

Do Not Resuscitate (Oklahoma Dept of Human Servces)

Covid-19 Form for Active Patients

Covid-19 Form for Non-Patient

Disclaimer

Low Cholesterol Diet Plan

Handouts

Kegel Exercise for Women (Ohio State University)

Advance Directives "Living Will" (United Regional)

​Medical Records Release to Dr. Myrna C. De Asis

Diabetes Prevention (Wichita County Public Health District)

My Time - Record Personal Info and Wishes (Hospice of Wichita Falls)

​​Privacy Notices & Patient Rights (HIPAA)

Notice of Privacy Practices

Shingles Vaccine - What You Need to Know

Employment Application

FMLA:  Family and Medical Leave Act (Dept. of Labor)

Noticia de Practicas Privadas

​Patient Assistance Program for Prescription Drugs

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Blood Pressure Log

Kegel Exercise for Men (Ohio State University)

Do Not Resuscitate (Texas Dept of State Health Services)

Fasting Blood Sugar Log

Diabetes Education (Wichita County Public Health District)

New Patient Registration Form

Forms

Internal Medicine - Primary Care

Cologuard easy-to-use Colon Cancer Screening Test

Medication List

​​​Immunization Schedule for Adults (CDC)

Medical Power of Attorney (Texas Medical Association)

Purine Restricted Diet

1800 Calorie Meal Plan (Novo Nordisk)

Call Us:  (940) 763-8077

​​Myrna C. De Asis, M.D., P.A.​