Forms for Patients

New Patient Registration Form
Fill out this form if the patient is over 18 years of age.
Please download file and print information.
Patient Registration Form.pdf
Adobe Acrobat document [56.1 KB]
Pediatric History Form
Fill out this form if your child will be the patient and he/she is under 18 years of age.
Please download file and print information.
Pediatric-Patient-History-Form.pdf
Adobe Acrobat document [139.2 KB]
Health History
All patients must fill out this form.
Please download file and print information.
HealthHistory.pdf
Adobe Acrobat document [161.7 KB]

Contact Us

Dr. Antonio M. Diaz Jr. M.D., P.A.

864 Central Blvd

Suite 100

Brownsville, TX 78520

 

Phone

(956) 541-5231

 

Fax

(956) 541-9588

Hours

Appointments 

Monday 8:00 am - 11:00 am & 2:00 pm - 4:00 pm

Tuesday 8:00 am - 11:00 am & 2:00 pm - 4:00 pm

Wednesday 8:00 am - 11:00 am

Thursday 8:00 am - 11:00 am & 2:00 pm - 4:00 pm

Friday 8:00 am - 11:00 am & 2:00 pm - 4:00 pm

 

Walk-ins are welcome between the hours of 8:00 am - 10:30 am and 2:00 pm - 3:30 pm, except for Wednesday afternoon

News

New Online Presence

Explore our new website to find out everything about our practice and the latest in medicine.

 

All announcements

Patient Information

Everything you need to know about your visit to the doctor.

More

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