Download Forms

Download Office Forms

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You will need a PDF reader in order to download these forms. If you do not have one installed on your computer, you may install Adobe's free Acrobat Reader here:

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HIPAA

New Federal laws require us to provide assurance of privacy and to attest that we will keep your personal and medical information confidential.

Download our HIPAA Forms here:

Notice of Privacy Practices

Acknowledgment and Consent

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Other Forms

These forms can either be printed out and then filled in by hand or filled in using your computer. Should you chose to fill them out using your computer, you will not be able to save your alterations, but you will be able to print them out and bring them to your appointment.

New Patient Registration

Health History

Authorization to Use/Disclose Health Information

Health Information Topics
Eddie Nassar Pediatrics

Eddie Nassar M.D., P.A.


Tel: (915) 881-4225
Fax: (915) 881-4197
5000 Doniphan, Suite 104
El Paso, TX 79932
Monday - Friday / 8:30am - 5pm
map & directions 
laura@eddienassarmdpa.com

 

 

Eddie Nassar Pediatrics
  • Board Certified in Pediatrics
  • Accepting New Patients
  • Newborn to 18 years
  • Walk-ins accepted
  • Back to School Physicals
  • Back to School Vaccinations
  • Most Insurance Accepted
  • El Paso Pediatric Clinic
  • Se Habla Espanol