Radiation Registration

Initial Consultation Requirements

In order for North Dallas Radiation Oncology Center (NDROC) to provide you with the most appropriate and optimal cancer care, it is important that we understand your medical history and the specifics of the previous care you have received.  Please ensure the following information is obtained by our office prior to your first appointment.

  • Medical Records

To better serve your needs during your first appointment, it is necessary for our facility to have all your Medical Records in our possession prior to that day.  Most medical facilities can directly send them to us on your behalf.  This may require a request by you via telephone or a release form.  Other medical practices may make copies of all the necessary documents in order for you to mail or fax to our office.

Medical Records to include:

1.  Physician’s notes from referring physician (if applicable)

2.  Radiology Reports

3.  Pathology Reports (i.e. biopsy)

4.  Surgical Reports (if applicable)

5.  Lab Work (blood test, i.e. PSA, CBC)

NDROC will gladly assistance you in obtaining or transferring the requested information.  Please call if you have any questions or if we can help you with the process in any way.  972-378-4114

  • Drivers License or Valid Picture I.D.
  • Medical Insurance Card(s)
  • List of Questions – Sometimes it is helpful for you to have a list of questions you may want to discuss with your physician.
  • New Patient Forms – Below are links to the New Patient Forms you will be asked to fill out once you arrive at our facility.  We offer them to you in advance in order to minimize your waiting room time and possibly provide a less hectic experience.  If you wish to print and fill out the forms prior to your visit only a ten minute arrival prior to your appointment is needed to complete any final paper work.  If you prefer to wait and fill out the forms at our facility we ask that patients arrive thirty minutes before their scheduled appointment time.  Unlike most medical practices, our facility generally operates on schedule.  Therefore, your early arrival is appreciated.

New Patient Initial Forms:

Radiation Registration Forms (click below to download)

CT Registration Forms Download

Radiation Registration Forms - 7 Pages

Notice of Privacy Practices

Notice of Privacy Practices - 5 Pages

Two Above Links Include

  • NDROCdisc7Patient Registration Form
  • New Patient Information Form
  • New Patient Questionnaire
  • Medication/Allergy List
  • Assignment of Benefits
  • Authorization for Use or Disclosure of Protected Health Information
  • Acknowledgment of Review of Notice of Privacy Practice
  • Notice of Privacy Practice