Patient Forms
Request for Medical Records
For TLC Surgery patients requesting their medical records to be released to another doctor’s office, please download and complete the form below.
Once completed, the form can be emailed to MA@tlcsurgery.com or faxed to (281) 971-4065.
Request for FMLA/Return to Work
For TLC Surgery patients that require FMLA paperwork be submitted or are requesting a letter to return to work after surgery, please email FMLA@tlcsurgery.com with the following information:
- Patient’s name
- Patient’s Date of birth
- Date of surgery
- Dates the patient has requested to be off from work
- Date of anticipated return
- Any special accommodations that TLC staff should be aware of when completing the request
Am I a Candidate?
The TLC Surgery Doctors have either authored or reviewed and approved this content.