New Patient Forms:
Please view, print, and complete the following forms as needed for your visits. The first 7 forms are needed for NEW patients.
Authorization to Disclose Health Information
[pdf-embedder url=”https://www.texasinstituteforneurologicaldisorders.com/wp-content/uploads/2017/03/1.-Patient-History-Form.pdf” title=”1. Patient History Form”]
[pdf-embedder url=”https://www.texasinstituteforneurologicaldisorders.com/wp-content/uploads/2017/03/2.-Registration-Form.pdf” title=”2. Registration Form”]
[pdf-embedder url=”https://www.texasinstituteforneurologicaldisorders.com/wp-content/uploads/2017/03/3.-Consent-for-Treatment-2.pdf” title=”3. Consent for Treatment”]
[pdf-embedder url=”https://www.texasinstituteforneurologicaldisorders.com/wp-content/uploads/2017/03/4.-Financial-Policy.pdf” title=”4. Financial Policy”]
[pdf-embedder url=”https://www.texasinstituteforneurologicaldisorders.com/wp-content/uploads/2017/03/5.-Disclosure-Form.pdf” title=”5. Disclosure Form”]
[pdf-embedder url=”https://www.texasinstituteforneurologicaldisorders.com/wp-content/uploads/2017/03/6.-Privacy-Policy.pdf” title=”6. Privacy Policy”]
[pdf-embedder url=”https://www.texasinstituteforneurologicaldisorders.com/wp-content/uploads/2017/03/OKLAHOMA-RELEASE-FORM.pdf” title=”OKLAHOMA RELEASE FORM”]
