Patient Forms

Save time in the waiting room by pre-printing these forms and bringing them filled out to your appointment.


Prior to Your Initial Visit

To optimize our ability to care for you, please have your previous care provider fax us the following information prior to your initial visit:
- Pertinent radiology reports and films
- Copy of your home address, work address and telephone numbers; date of birth; date of injury; name of adjustor, if applicable
- Copy of current insurance information so we may obtain timely PCP referral if required.
- Please provide name and social security number of the primary cardholder

Our Fax #

Fort Worth Area: 855-810-8998
Dallas Area: 877-959-4622