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New Patient Forms
We offer our new patient 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 Patients Must Complete These Two Forms Online in Advance of Their Appointment.
New Patient Registration Paperwork (All Patients)
AND
New Patient (Males Only) Consent Forms
OR
New Patient (Females Only) Consent Forms
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)
UHC New Patients ONLY: Please PRINT and fill out these forms IN ADDITION to the online New Patient forms listed above:
UHC New Patient Summary Form-Must Complete
UHC-Lower Extremity Functional Scale (LEFS)-Complete if Applicable
UHC-Disabilities of the Arm, Shoulder and Hand-Complete if Applicable
CIGNA New Patients ONLY: Please PRINT and fill out these forms IN ADDITION to the New Patient forms listed above:
Free AdobeReader®
Each form is a PDF document file. If you do not already have AdobeReader® installed on your computer, click the Adobe® image to download for free.
