Skip to content
Baylor Scott & White Medical Center – Uptown
Baylor Scott & White Medical Center – Uptown
Patients
Cafeteria & Dietary
Documents and Forms
Online Concierge
Patient Portal (Existing Patients)
Patient Portal (New Patients)
Patient Registration Form
Pay Bill Online
Spiritual Support
Surgery FAQs
Other
Accessibility Statement
COVID Updates
Good Faith Estimate
Hospital Pricing Information
Información en Español
Non-Discrimination Notice
Patient Rights & Responsibilities
Privacy Policy
Quality Care and Safety
Social Media Terms of Use
Terms of Use
Your Privacy
Su Privacidad
Surprise Medical Bills
Physicians
Specialties
24/7 Emergency Department
Advanced Robotic Surgery System
Bariatrics
Colon & Rectal Surgery
General Surgery
Imaging and Diagnostics
Ophthalmology
Orthopedic Surgery
Otolaryngology (ENT)
Pain Management
Plastic and Reconstructive Surgery
Spine Surgery
Surgical Oncology
Total Joint Replacement Center
About
Awards
Employment Opportunities
Patient Recommendations
Contact
Location
New Patient Portal
Existing Patient Portal
Patients
Cafeteria & Dietary
Documents and Forms
Online Concierge
Patient Portal (Existing Patients)
Patient Portal (New Patients)
Patient Registration Form
Pay Bill Online
Spiritual Support
Surgery FAQs
Other
Accessibility Statement
COVID Updates
Good Faith Estimate
Hospital Pricing Information
Información en Español
Non-Discrimination Notice
Patient Rights & Responsibilities
Privacy Policy
Quality Care and Safety
Social Media Terms of Use
Terms of Use
Your Privacy
Su Privacidad
Surprise Medical Bills
Physicians
Specialties
24/7 Emergency Department
Advanced Robotic Surgery System
Bariatrics
Colon & Rectal Surgery
General Surgery
Imaging and Diagnostics
Ophthalmology
Orthopedic Surgery
Otolaryngology (ENT)
Pain Management
Plastic and Reconstructive Surgery
Spine Surgery
Surgical Oncology
Total Joint Replacement Center
About
Awards
Employment Opportunities
Patient Recommendations
Contact
Location
Consumer Access Request Form
Consumer Access Request Form
Name
*
Date of Birth
*
Month
Day
Year
Telephone Number
*
Address
*
City
*
State
*
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
Zip Code
*
Email
*
If you do not have an email address, please type "none". Fields with * are required
Information Being Requested
Specific pieces of personal information, collected or shared with third parties and for what business/commercial purpose.
Request to delete data.
We do not sell personal information that we have collected from consumers to any third parties. By completing this form, you are making a Consumer Access request under California Consumer Privacy Act for personal information collected, held and disclosed about you that you are entitled to receive. On this date
, I affirm that I am the consumer, or authorized by the consumer to act on their behalf. I understand that misrepresentation may be subject to legal action.
Go to Top