4 Locations: Boerne & San Antonio, TX (830) 340-1100
Patient Resources

Official Patient Forms & Disclosures

To ensure smooth coordination and save time during your visit, please review and download the appropriate forms below. In compliance with Privia Health policies, these link directly to the latest official documents.

Privia Care Center Forms

Please review and click the links below to access the latest direct PDF downloads from Privia Health.

Notice of Privacy Practices (PDF)

Describes how health information about you (as a patient of this Care Center) may be used and disclosed, and how you can get access to your individually identifiable health information. Please review this notice carefully.

Download Document

Authorization for Release of Medical Information (PDF)

Allows patients to authorize the disclosure of their health information to a designated individual, company, agency, or facility.

Download Document

Authorization and Consent for Treatment (PDF)

Autorización y Consentimiento Para el Tratamiento

All patients must provide their consent for treatment, communications (calls, emails, and text messaging), and agreement of financial responsibility.

Download Document

Preferred Contacts (PDF)

Contactos Preferidos

Patients are encouraged to complete and return the Preferred Contacts Form but it is not required.

Download Document

Financial Policy (PDF)

This form advises patients of their complete financial responsibility for all medical services received without regard to insurance eligibility or coverage determinations.

Download Document

Language Services

Language assistance services, free of charge, are available to you. Notice of Nondiscrimination / Servicios de asistencia lingüística.

View Notice

Ready to Get Started?

Schedule a comprehensive psychiatric evaluation at any of our four San Antonio area locations.

Privia Medical Group

Health 210 Psychiatry is a proud member of Privia Medical Group — a high-performance physician network committed to coordinated, patient-first care across San Antonio and beyond.

Health 210 Psychiatry

Contact & Hours

Phone: (830) 340-1100

Hours: Mon - Fri: 8:00 AM - 5:00 PM

Boerne: 27511 I-10 W, Bldg 5

Stone Oak: 18818 Meisner Dr, Ste 107

Westover: 5250 Rogers Rd, Bldg 2

Medical Center: 2128 Babcock Rd, Bldg 1

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