New Practice Member Forms
We offer our new practice member forms online so you can download and complete these forms in the convenience of your home prior to your first appointment. Please call us if you have any questions. (817) 421-4775
All New Practice Members Must Complete These Forms Online in Advance of Their Appointment.
Please call the office @ 817-421-4775 to have the forms sent to you.
- Auto Accident Paperwork (Please print, complete, sign and bring with you to your first visit)
- Doctor’s Lien (For 3rd Party or Auto Accidents WITH Lawyer – if using your own auto insurance (PIP) you do not need to fill this out)
- Need to send records to/from our office? Click HERE
UHC New Practice Members ONLY: Please PRINT and fill out these forms IN ADDITION to the online New Practice Member forms listed above:
- UHC New Practice Member Summary Form-Must Complete
- UHC-Back Index-Must Complete
- UHC-Neck Index-Must Complete
- UHC-Keele STarT Back Screening Tool-Must Complete
- UHC-Lower Extremity Functional Scale (LEFS)-Complete if Applicable
- UHC-Disabilities of the Arm, Shoulder and Hand-Complete if Applicable
