Patient Forms


 

New Patient Forms:

New Patient Packet

To enroll as a new patient

Physician Referral Form

For a physician to refer a patient to Lone Star Infusion

Release of Information

To authorize a medical provider to release information to Lone Star Infusion

 

Before Your Appointment:

Complete these forms before each appointment:

  • Consent and Instructions
  • QIDS

 

To Submit:

  • Follow the links on this page. A copy of your paperwork will be automatically sent to our office when you complete the paperwork in the provided links and follow the instructions provided.

Location

Energy Corridor
Houston

14740 Barryknoll Lane, #140

Houston, TX 77079

Fax: 281-719-9393

Email: mail@lonestarinfusion.com

Hours of Operation

  • Monday

    9:00 AM - 5:00 PM

  • Tuesday

    6:00 AM - 4:00 PM

  • Wednesday

    6:00 AM - 4:00 PM

  • Thursday

    6:00 AM - 4:00 PM

  • Friday

    6:00 AM - 4:00 PM

  • Saturday

    6:00 AM - 4:00 PM

  • Sunday

    Closed