1. health and fitness

Care Team
Themos Dassopoulos, MD
3600 Gaston Ave
Suite 711
Dallas, TX 75246
469-800-7180 (main)
469-800-7190 (fax)
[email protected]
Adriana Cardenas, Medical Assistant
Taylor Foltz , Check In/Out
Management Team
Matthew K. Bertucci, MSHA
Practice Administrator
Jennifer N. Escolero
Operations Manager
WELCOME TO BAYLOR CENTER FOR IBD!
Thank you for choosing our practice. We look forward to providing you with professional health care in a friendly
and welcoming environment. This letter is designed to provide you with important information that you should
know as you prepare for your visit. Please take a moment to read through. If you have any questions, we will be
happy to discuss them with you.
Your First Appointment:
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There are 3 sets of forms required for new patients listed below. Please fill these out completely You can
either fax or email your forms to the clinic. This helps reduce delays at your appointment time.
1. Release of Information form: We need this form as soon as possible in order to request your medical
records from other providers involved in your care. If our office does not receive this form in a timely
manner then our office will be unable to obtain medical records relating to your condition. In order for
your appointment to run smoothly and in a timely manner we require to have medical records prior to
appointment. If we do not receive your release of information in a timely manner we will unfortunately
have to reschedule your appointment.
2. Assessment Form: The assessment is detailed but it is so we can provide the best care to you! Please
take your time filling this form out and give us as much detail as you need to. Dr. Dassopoulos requires
that the health assessment be done prior to you coming in for your appointment. Dr.Dassopoulos will
evaluate your history and present day symptoms to prepare for your upcoming visit.
3. Registration Forms: You may bring these to your appointment.
Due to the complex nature of the specialty care that we provide, your appointment may take 2 – 3 hours
from the time you check in to the time you check out.
What you need to bring with you to your appointment:
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Completed—Registration Packet
Your insurance card & picture ID
Any updated medical records/CD’s that are related to your condition that have not already been sent
Your medications
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Office Hours:
Monday
8:30am – 4:30pm
Tuesday
8:30am – 4:30pm
Wednesday
8:30am – 4:30pm
Thursday
8:30am – 4:30pm
Friday
8:30am – 4:30pm
Emergencies: For life-threatening situations, call 911. If you have an urgent problem after hours, please call our
office and you will be forwarded to our answering service. They will page the physician on call.
Appointments:
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To schedule appointments please call 469-800-7180.
As a courtesy to other patients and staff, please call the office as soon as possible if you are unable to keep
your appointment or are going to be late.
Our Partnership with You:
What you expect from us:
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You will be treated with respect and dignity.
Professional services that are both timely and appropriate.
You will be kept informed of any clinic delays.
Information about your plan of care that will help you reach an educated decision about your health.
Time to answer all of your health care-related questions.
Teaching/Educational material will be provided
Information about what to expect from the Medical Practice billing process.
Your records will be kept confidential except when you have given consent to do otherwise.
The option to express your concerns, compliments or complaints with any of our staff. We promise to pay
attention to and follow-up all of your concerns.
What do we need from you?
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To inform IBD staff of any pertinent changes in your contact information, other health issues, medications,
primary and other physicians, insurance, and employment.
To arrive on time for scheduled appointments.
To call the office as soon as you are aware you cannot make an appointment or are running late.
To provide payment for services not covered by insurance within 90 days.
To pay all co-payments and/or previous balances at the time of check out.
To follow the recommended treatment plan and inform care team of any changes.
To ask questions if directions and procedures are not understood.
Thank you! We look forward to serving you!
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