713.383.0777 (Houston, TX)
281.829.5999 (Katy, TX)

Debra M. Emmite, M.D.

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Patient Information

Patient Forms
Office Visits | What to Bring to Your First Appointment
Payment Information | Privacy Practices

Patient Forms

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Please complete the first 3 forms and bring with you to your first appointment.

Office Visits

Please arrive at least 10-15 minutes prior to your appointment as to allow sufficient time to complete any necessary paperwork. If you arrive for you appointment more than 15 minutes late, please be aware that there is the possibility that your appointment may be rescheduled, as to not inconvenience the next scheduled patient.

If you cannot keep your appointment, please call 713.383.0777 or 281.829.5999 to cancel or reschedule your appointment at AT LEAST TWENTY FOUR (24) HOURS IN ADVANCE! Failure to do so will result in cancellation fees equal to that of a missed appointment.

When an appointment is made with Dr. Emmite, time is specifically allocated for you. When an appointment is missed, or the patient "no-shows", another patient that needed to be seen may have been unable to do so because that time slot was already taken. Missed or "no-show" appointments will be charged.

Please note that in the event of a missed, rescheduled, or cancelled appointment, your medications may not be refilled.

Prescriptions will be written at Dr. Emmite's office only. Phone refills will be accepted only in the case of an emergency, which does not include missed appointments.

What to Bring to Your First Appointment

Please arrive early so that we can complete your initial paperwork. Also, please bring the following:

Payment Information

Dr. Emmite does not accept insurance. All patients must be self pay. If you wish to use your health insurance, you are asked to file it yourself. Dr.Emmite would be classified as a non-preferred provider. Dr. Emmite gives each patient a detailed receipt with her tax identification number, a diagnostic code, and a procedure code. The date of service and the payment made will be on each receipt along with Dr. Emmite's signature. Please file this receipt with your insurance according to the policies of your health plan.

AT THIS TIME ONLY CHECKS AND CASH ARE ACCEPTED AS FORMS OF PAYMENT.

Privacy Practices

Our Notice of Privacy Practices describes how medical information about you may be used and disclosed and how you can get access to this information. It is given to all new patients, and a copy is available upon request.
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