Choose the ‘New Patient application’ that applies to you, print, fill out, and sign
New Patient Application w/Health insurance
Medicare New Patient Application
Auto Crash New Patient Application
Non-insurance/ underinsured New Patient Application
Next, print, complete, and sign the Functional Rating Index Questionnaire (please do not score we will do it for you).
Functional Rating Index Questionnaire
**Please bring all forms, identification, and insurance card (if applicable) with you to your new patient appointment
