Below you’ll find links to common forms we use to collect information about our patients. Please download and print these forms and present them at the time of assessment or fax them to our office at (817) 404-2298.

  • The Excel Center Referral Information Card
    The referral information card simply lets us know who referred you to our services (physician, mental health provider, social service provider).  We strictly follow HIPPA (privacy rules) but should you request information be sent to your referring provider, we are happy to comply with your written release of information.

 

Questions? Please contact us.



Physicians are on the medical staff of Millwood Hospital, but, with limited exceptions, are independent practitioners who are not employees or agents of Millwood Hospital. The facility shall not be liable for actions or treatments provided by physicians.

Model representations of real patients are shown. Actual patients cannot be divulged due to HIPAA regulations.