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LuxSci helps ensure HIPAA-Compliance for email and web services.
Secure Internet Services

Below is a list of medical forms available for you to  securely submit to our offices before your appointment.  Your form is transmitted to us through a secure, encrypted connection to protect your information.

Appointment Request Form

Appointment Request Form- Click

Please fill out the following forms prior to your appointment:

1. Patient Registration Form – Patient Authorization (Required at Visit)

Patient Authorization Form – Click

Formulario De Registro Del Paciente

2. Patient Registration Form – Initial History (Required at Visit)

Initial History Form – Click

Formulario De Historia Inicial

3. Applicable Injury History Form (Required at Visit)

Back History Form – Click
Elbow History Form – Click
Foot / Ankle History Form – Click
Hip History Form – Click
Knee History Form – Click
Neck History Form – Click
Shoulder History Form – Click

–Please note that the Patient Authorization Form, Initial History Form and the Applicable Injury History Form must be filled out prior to your visit.