In order to exchange providers' direct addresses for direct messaging, please complete this questionnaire and we will contact you shortly afterward. For any questions regarding the questions, please contact us directly at
Thank you so much!
 !!! For urgent patient information request, please contact Baylor College of Medicine directly at 713-798-4951 !!!

Question Title

* 1. Tell us about your direct address needs, why you would need to exchange health information electronically with us (please select all that applied).