Patient Forms

Before your appointment with us, quickly and conveniently access patient forms from our practice.

Access Secure Online Patient Forms

Online Forms

Your request will be processed within 24 hours, during normal business hours. If you do not receive confirmation of your request within 48 hours, please contact our office by phone.

 

Download Patient Forms

Download Patient Forms

Please bring your completed forms with you to our office at the time of your visit. To view the documents listed on this page, you will need Adobe Reader.

General Office Policies

Thank you for choosing Texas Spine Associates as your healthcare provider. When planning your visit, please remember to bring your completed paperwork along with your insurance identification card. It is important that you arrive at least 15 minutes early to complete patient check-in. Late arrival or failure to have your paperwork completed for your appointment may result in it being rescheduled.

If your insurance company requires a referral to see a specialist, you must bring the referral to your appointment or verify that our office has received the referral. If you are not sure whether you need an authorization or referral, you should contact your primary care physician’s office. In addition, if your insurance company denies your claim due to a pre-existing clause, you will be responsible for all charges not covered by your insurance company.

It is essential that you bring with you any medical records and x-ray films to assist the physician in determining your treatment.

You will be expected to provide payment at the time of your visit in the amount of any co-payment required by your insurance plan. Payments can be in the form of cash, check or credit card.

Prescriptions: Please contact your pharmacy to request medication refills. Your pharmacy will notify our office of your refill request. We require 24 hours for refill request. Please be aware that refills received on Fridays or holidays may not be authorized until the next business day.

Physician Emergency: A physician is on-call 24 hours a day for emergency situations. If you wish to make an appointment, have prescriptions refilled, or obtain x-ray or lab results, please call during regular business hours.

In case of a life-threatening emergency, call 911 or seek treatment at the nearest emergency room.

Clinical Questions: Please be aware if you call our office with a clinical question, our physicians and nursing staff are in clinic during the day and cannot be called away from patients. Our receptionist will get your message to our clinical staff and they will return your call as soon as possible. (NOTE: if you have recently had surgery, please notify our receptionist of any problem you are experiencing, and she will immediately notify a member of our clinical staff.)

Patient Forms:

Please be aware that we charge $25.00 to complete the following paperwork:

  • AFLAC
  • FMLA
  • Disability

We require 5-7 business days to complete any paperwork given.