Lake Pointe Medical Partners - Monika T. Hearne, M.D. - Obstetrics & Gynecology


		Pediatrics Family Medicine Obstetrics & Gynecology Internal Medicine Sports Medicine


	Click here for an aerial map of this location and exact driving directions.

	FORM FOR SPORTS PHYSICAL :: CLINIC INFORMATION

Lake Pointe Medical Partners - Monika T. Hearne, M.D.

	:: LOCATION

Obstetrics & Gynecology
9500 Lakeview Pkwy., Suite 200
Rowlett, TX 75088

Phone - (972) 475-0960
Fax - (972) 412-5964

Hours
Monday - Wednesday 9 a.m. - 5 p.m.
Closed for lunch 1 p.m. - 2 p.m.
Thursday 2 p.m. - 6 p.m.
Friday 9 a.m. - 1 p.m.

Location Information
Directions from I-30: Take exit 64, Dalrock, and drive north on Dalrock for about 3 miles. Turn right (east) on Lakeview Parkway and drive about a 1/2-mile. The office is located on the southeast corner of Lakeview Parkway and Scenic.

Map
Click here for an aerial map of this location and exact driving directions.

	:: BIOGRAPHY - DR. MONIKA T. HEARNE

	Monika T. Hearne , M.D.

	Specialty

	Medical School

	Obstetrics and Gynecology

	University of Texas Medical Branch School of Medicine Galveston, Texas

	Residency

	Memberships

	Orlando Regional Medical Center Orlando, Florida

	American College of Obstetricians and Gynecologists American Medical Association Texas Medical Association

	Residence

	Dr. Hearne lives in Sunnyvale with her family.

	:: FORMS

Adult New Patient
For adults (age 16+) with a new patient appointment
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Consent for Treatment
Form giving Lake Pointe Medical Partners consent to give you treatment
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Notice of Privacy Practice
Describes how medical information about you may be used and disclosed and how you can access this information.
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Receipt and Notice of Privacy Practices
Describes how medical information about you may be used and disclosed and how you can access this information. HIPAA requires all patients to complete this form.
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Medical Release
Form authorizing healthcare provider to release your medical information to Lake Pointe Medical Partners
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Financial Policy
Explains payment of services
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Medical Information Release
Authorizes Lake Pointe Medical Partners to release your medical information to specific entities.
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Frequently Asked Questions
HIPAA as it relates to our patients.
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Request for Correction / Amendment to Record
Allows you to request a correction / amendment to your medical record.
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Know Your Benefits
This pamphlet can assist you in learning about your insurance benefits, including questions to ask your provider.
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Broken Appointment Policy
This form describes Lake Pointe Medical Partners' policy on broken appointments
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Credit Card Policy
This form describes Lake Pointe Medical Partners' policy on credit cards
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	:: SERVICES OFFERED

	:: HOSPITAL AFFILIATION

Saint Francis Medical Partners - Bartlett - Services Offered

• New Patients Always Welcome

• Same-Day Visits Available

• Accept Most Insurance Plans

• Complete Health Care for Women

• Gynecological Exams

• Family Planning

• Complete Pregnancy Care - Both normal and high-risk pregnancies and births.

	6800 Scenic Drive Rowlett, TX 75088 [t] (972) 412-2273 www.lakepointemedical.com