Get the free Robert A. Zajac M.D., P.A. Stoneterra Medical Plaza

Robert A. Ajax M.D., P.A. Stoneterra Medical Plaza 150 E. Monterrey, Suite. 170 San Antonio, Texas 78258 Telephone: 2104812800 Fax# 2104812834Patient Agreement As a patient of Dr. Ajax, I acknowledge

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1. Start by gathering all your personal information such as your full name, address, contact number, and date of birth.
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3. Download the 'Patient Information Form' or any other relevant forms that are required to be filled out.
4. Open the downloaded form using a PDF reader or print it out if you prefer to fill it out manually.
5. Carefully read the instructions provided on the form and begin entering your personal information as requested. Make sure to provide accurate and up-to-date details.
6. If there are any specific medical history or health-related questions on the form, answer them honestly and to the best of your knowledge.
7. Fill in the required fields, such as insurance information, emergency contact details, and any additional information that may be required.
8. Double-check all the information you have entered to ensure accuracy and completeness.
9. Sign and date the form as indicated.
10. Once you have filled out the form, you can either submit it online if there is an option available on the website or bring the completed form with you during your appointment with Robert A. Zajac MD.

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