NonSurgical Medical Group offers our new patient forms online so you can complete them in the convenience of your own home, before you arrive for your first appointment to our office.
- If you do not already have AdobeReader® installed on your computer, Click here to download.
- Download the necessary form(s), print them out, and fill in the required information.
- Feel free to FAX or email us your printed and completed form(s) or bring them with you to your first appointment. This will not only save you time when you arrive but will also give us a head start toward understanding your health situation.
Patient Information Forms (Required of ALL New Patients)
These medical intake forms provide you the first opportunity to let us know about your situation – the history and current state of your health. The patient information forms serve to open the conversation regarding your health related needs.
Download Patient Demographic Intake Form
Neuromodulation (rTMS) Forms
The Neuromodulation (rTMS) forms are required of patients with centralized pain conditions (e.g. Neuropathic Pain, Fibromyalgia, etc.) who are interested in determining their potential candidacy to treat their painful condition using our neuromodulation procedures.
Personal Injury Questionnaire
Required ONLY of patients who are filing a personal injury claim… and this questionnaire is needed in addition to the medical intake forms.
The personal injury questionnaire gives you the chance to tell us how your auto accident or other injury occurred. You will also use this set of forms to communicate what you have experienced physically, emotionally, or otherwise since the injury. Finally, the personal injury questionnaire gives us insight into the origin of your condition, which helps determine your best treatment and is used to support your claim.
By the way, if you need an attorney and don’t know where to begin in your search, don’t worry… we can refer you to the best in Orange County, California.