To make the referral process simple and fast, please feel free to download our referral below. Once completed, please fax the referral to 210-342-5325. If you have any questions, please do not hesitate to call us at 210-342-5300.
In order to help us expedite your initial visit and better serve you, we ask that you please bring the following completed forms to your first visit:
1) Patient Information Record
2) Cancellation policy
3) Please complete the form related to the part of the body for which you are seeking treatment. If you are unsure of which form to complete, please call our office for assistance.
a. Neck Pain – Neck Disability Index form
b. Upper Back, Shoulder, Arm, or Hand Pain – Disabilities of the Arm, Shoulder, Hand (DASH) form
c. Low Back Pain – Oswestry Disability Index form
d. Leg Pain – Lower Extremity Functional (LEFS) Scale
e. Swelling of the Arm – Disabilities of the Arm, Shoulder, Hand (DASH) form
f. Swelling of the Leg – Lower Extremity Functional (LEFS) Scale
g. Breast cancer – Disabilities of the Arm, Shoulder, Hand (DASH) form