Patient Forms

Patient Forms

* Patients – please print out the forms needed for your appointment, fill them out and bring them with you to your appointment.

• New Patient Forms
  
• Established Patient Form
• Medical History Form (Dr. Michael House patients only)

Physical & Occupational Therapy Patient Forms

• New Patient Forms

Extremity Forms

• Ankle/Foot
• Elbow
• Hand & Wrist
• Hip
• Knee
• Neck & Back (Dr. Guess, Dr. Alder & Dr. Sethi patients only)
• Shoulder
• Pain

Additional Forms

• Consent for Treatment of Minor Children
• Discrimination Policy
• Financial Policy
• Medication Policy
• Medical Records Release Form
• Notice of Privacy Practices
• Disclosure of Physician Ownership
• OrthoTexas Patient Code of Conduct