Appointment Forms

Online Medical Forms

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

Below is a list of Adobe PDF forms available for you to download and securely submit to our offices before your appointment. You may also save a copy for your records.

Click on the applicable form and if prompted, download it to your computer. Next open the PDF form, fill in the fields, and click the submit button at the end of the form. Note: requires ADOBE PDF Reader on your computer.

Appointment Request Form

Appointment Request Form- Click

1. Patient Registration Form (Required at Visit)

Initial History Form – Click

Formulario De Historia Inicial

2. Patient Registration Form (Required at Visit)

Patient Authorization Form – Click

Formulario De Registro Del Paciente

3. Applicable Injury History Form (Required at Visit)

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