Neurological Clinic of Texas, PA

Excellence in Neurological Care

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For your convenience, we have provided forms which you can download and pre-fill at home.  These are the same forms that you would normally have to fill out at our office. The forms are in Adobe PDF format (?), they require Adobe Reader 7.0 or later.

 

  • Save time. Fill out at your convenience.  Have necessary important information handy at home.
  • Fill out forms electronically or fill out by hand.  The forms can either be first printed out, then filled out by hand.  Or, they can also be filled out directly by typing in your responses directly into the electronic document, and then printed out.
  • INSTRUCTION:  Click on the document links below to open the PDF file, or right-mouse-click on the link and select Save Target As to download the PDF document first to your computer.

 

NOTE:  IF YOU CHOOSE TO FILL OUT ELECTRONICALLY, DUE TO THE ADOBE PDF LIMITATION YOU CANNOT SAVE A FILLED OUT DOCUMENT.  YOU MUST FINISH FILLING OUT THE FORMS IN A SINGLE SITTING AND BE READY TO PRINT IT OUT.

 

 New PatientsNew Sleep Patients
General

 NewPatient.pdf

(8 pages, 970KB) 

SleepNewPatient.pdf

(14 pages, 1,368KB) 

Obtain Health Record

Authorization

ObtainMedRecordAuth.pdf

(1 page, 185KB) 

 

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