Desert Institute of Spine Care
Specializing in Non-Operative and Operative Treatment of the Spine.
New Patient Forms
Download New Patient Forms
New Patient (Intake) Forms are available to download in PDF format both in English and Spanish.
Forms must be completed prior to being seen by the doctor. They can be completed before coming to the office or at the office.
You will need to have Adobe Acrobat Reader installed to be able to open the files. Click on the Adobe Icon below to download the Free Acorbat Reader. A new browser window will open. When the download is complete, close the Adobe window.
Select the language you want. The form will open in a new window. You can either save or print the form.
Download Entrance Applications
Entrance Application (Insurance or cash pay)
Complete this packet if you weren't involved in an auto accident or workers compensation claim. If this visit is related to either an auto accident or work comp case however the case(s) are currently closed. This is the packet that you’ll need to complete.
Entrance Application (Auto Accident or Personal Injury)
Complete this packet if you were involved in an auto accident or personal injury case. You'll still complete the form if heath insurance is being used.
Entrance Application (Workers Compensation)
Complete this packet if you were injured on the job and your adjuster has either sent a referral or contacted our office to coordinate the initial consultation. DO NOT complete this form if you have a closed claim that you are trying to reopen. If you are trying to re-open a closed claim you will need to pay cash for your consultation. Therefore you would complete the insurance packet.