new patient information
NEW PATIENT PAPERWORK
In order to expedite your appointment, we have provided our new patient paperwork for you to fill out ahead of time.
We also ask that you please bring photo identification and a copy of your most updated insurance card. If you have any x-rays that were taken at an outside facility, please bring the CD to your appointment. and signed by the legal guardian.
*Adult patients seeing Dr. Dehne or Dr. Gottschalk can click here.
WE CAN VIEW FILMS ONLINE FROM THE FOLLOWING LOCATIONS:
-
ADC (Austin Diagnostic Clinic)
-
ARA (Austin Radiological Association)
-
ARC (Austin Regional Clinic)
-
Seton facilities
-
CPRMC (Cedar Park Regional Medical Center)
-
River Ranch Radiology
-
5 Star ER
*If you are seen over at the Marney Paul Specialty Care Center and have questions regarding scheduling or changing an appointment, please call (512) 324-0137.
CONSENT TO TREAT FORM
In the event that the legal guardian WILL NOT be able to accompany your child to the appointment, the consent to treat form must be filled out and signed by the legal guardian.
We will be unable to treat the patient without this consent. In addition, all patients must be accompanied by an adult if they are under the age of 18. (Physical therapy patients may be seen at 16, with parent’s permission).
18+ RELEASE OF INFORMATION
This form is necessary for patients that are over 18 years old to allow us to communicate with their parents or other caregivers about the patient’s medical treatment and history.