Barry F. Gritz, MD

Barry F. Gritz, MDBarry F. Gritz, MDBarry F. Gritz, MD

Barry F. Gritz, MD

Barry F. Gritz, MDBarry F. Gritz, MDBarry F. Gritz, MD
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New Patient Forms

 Once you have called the office and scheduled a New Patient appointment, you can print the New Patient forms below, complete and email to barrygritzmd@gmail.com or bring with you to your appointment. 

 If you have any questions regarding the New Patient forms please call the office at 713-869-7400. 

CONFIDENTIAL HISTORY 2024 - 410 (pdf)Download
Patient Agreement 2024 pg1 - 410 (pdf)Download
Patient Agreement 2024 pg 2 - 410 (pdf)Download
Release of Information 2024 - 410 (pdf)Download
Acknowledgement 2024 - 410 (pdf)Download
Provider Acknowledgement 2024- 410 (pdf)Download
Primary Insurance 2024 - 410 (pdf)Download
Medicare Medicaid Opt Out 2024-410 (pdf)Download
Office Cancellation Policy 2024 - 410 (pdf)Download
Additional Information Needed 2024 - 410 (pdf)Download

Copyright © 2025 Barry F. Gritz, MD - All Rights Reserved.

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