accessibility ACCESSIBILITY

Patient Forms, Financing

The link below provides access to the New Patient Forms that should be completed for your first visit.  Completing these in advance of your appointment can reduce your time in our waiting room.


If you are unable to open this file, please feel free to contact our office at 979-316-2122 and we will gladly send you the forms by email, mail or fax.

Or request appointment and fill out information online:

We accept cash, checks, money orders and all major credit cards as payment for services when rendered. 

For major procedures, we also offer our patients several financing options, including Layaway. 

 Care Credit

 Care Credit offers several No Interest Payment Plans.  You can visit their website to apply online or call them for instant approval.


We offer Instant On-the-Spot Financing through Texas Dow Employees Credit Union.  You can apply in our office at the time of your visit or through their website.  If you are not a member of the Credit Union, they will automatically set up an account for you when your financing is approved.

Our practice is pleased to present flexible payment plans through Lending Club Patient Solutions. Lending Club Patient Solutions offers:
• Plans with low fixed rates & low monthly payments that never change over the life of the loan

• Patient-friendly,True No-Interest Plans with no retroactive interest

• No upfront payments

• No prepayment penalty

It’s easy to calculate your potential monthly payments. Simply complete a short application which displays fixed rates and monthly payments available for Extended Plans, all without impacting your credit score.

For more information, simply ask a team member or visit


Prosper Healthcare Lending is the premier financing company in the healthcare industry.
Here are some of the benefits you’ll receive with a loan from Prosper Healthcare Lending:
• Immediate decisions without affecting your credit!
• Longer terms for lower monthly payments
• No collateral required
• No prepayment penalties
• Fast & easy loan inquiry process
• 100% Confidential

Contact Us.We encourage you to contact us with any questions or comments you may have. Please call our office or use the quick contact form.

Contact Us

We encourage you to contact us with any questions or comments you may have. Please call our office or use the contact form below.