Patient Forms

Please print the following forms, complete, and bring to your appointment.

Patient Forms

• New Patient Forms (English)
• Loss of Enjoyment Summary
• Medical Records Release Form
• Concussion Questionnaire
• Montreal Cognitive Assessment
• Release of Personal Injury Care Form

Formularios Para Pacientes (Para Hispanohablantes)

• Formularios Para Pacientes Nuevos
• Resumen de la Pérdida de Poder Disfrutar
• Fomulario de Solicitud de Divulgación de Historial Médico
• Registro de Dolor del Paciente de 12 Horas

Accepting New Patients

Texas Injury and Rehab Solutions is accepting new patients in our injury clinics. To schedule an appointment, please contact one of our clinics, or simply call (469) 210-7881.