Printable Patient Forms
For your convenience, UT Southwestern Medical Center offers several forms online that you can print and complete prior to your hospital stay or clinic visit. All are PDF files and open in a new browser window.
- Authorization to Disclose Protected Health Information (PDF)
- Authorization to Disclose Protected Health Information (Spanish) (PDF)
- Directive to Physicians and Family of Surrogates (PDF)
- Medical Power of Attorney (PDF)
- Out-of-Hospital Do-Not-Resuscitate (DNR) Order (PDF)
- Request to Receive External Records (PDF)