Medical Forms and Additional Documents
If possible, please complete the new patient information forms on this page prior to your first appointment at Tyler Headache Center. These documents are in Adobe PDF format. If you cannot read PDF files, you can Download Acrobat Reader free from Adobe.
HIPAA Authorization Form
Patient health information is protected by law. This form gives us consent to use your health information to provide you with the best care possible and obtain insurance reimbursement on your behalf.
Head Health History Form
This questionnaire collects vital information about your head health history, including issues that pertain to dental work and dental forces, pain symptoms and locations, accident trauma, habits & lifestyle.
New Patient Intake Form
This form is used to compile contact information for you and your spouse (if applicable), emergency information, as well as dental and medical history.