FOSSIL CREEK FAMILY MEDICAL CENTER

7510 North Beach Street Fort Worth, TX | 817-498-1818

Doctors

  • Doctor David Simonak DO
  • Doctor Ryan Simonak DO
  • NP Robin Sustala APRN
  • PA-C Jake Duncan
  • NP FNP-C Isatu Wellington
  • Office Staff

Forms



Privacy Notice (patient portal) - How we protect your privacy




Privacy Notice Acknowledgement (patient portal) - Acknowledgement Privacy Notice has been read




Privacy Releases (patient portal) - Required information to release information




Patient Demographics - Information about our patient




Patient History - First page of Patient History




Patient History (page 2) - Second page of Patient History




Financial Policy - Financial Policy




Commercial Driver Medical Exam Report - Commercial drivers, download this form to complete Section 1, prior to your D.O.T. Physical Exam




D.O.T. Pre-Exam Important Information - To provide a more efficient and accurate exam, please review this information to make sure you're prepared for your appointment.