Mercy Health Quailbrook

Save time by completing your patient registration forms at home.

• Registration form
• Patient Health History
• Financial policy
• Authorization to use or share Protected Health Information (PHI)
• Authorization to use or share Protected Health Information (PHI) instructions
• PHI communication resource tool
• Advance directive - English - Spanish - Vietnamese
• Oklahoma notice to patients
• Notice on Health Information Practices

Mercy Health Quailbrook

4345 W. Memorial Rd.
Suite 110
Oklahoma City, OK 73134
Phone: 405-749-7070
Fax: 405-749-7090

Hours: Mon-Fri, 8 am to 5 pm
Extended hours available.

Clinic Manager:  Tina Brawdy

	Jason K. Hart, MD Family Medicine It’s about listening to the needs of my patients.
	Visal Pok, MD Family Medicine My goal is to treat patients with respect and compassion.
	Elizabeth Wickersham, MD Family Medicine I have the distinct privilege of loving my job.