Patient Registration Forms

Initial Intake Packet

• Injury History
• Consent Contract
• Texas Authorization to Release Records

Rating Forms

• Adult General Information
• Symptom Rating Form
• Symptom Checklist
• Pain Severity Rating Form
• Patient Competency Rating (Self Form)
• Trauma Rating Form

Informant Forms

• Patient Competency Rating (Informant Form)

Spanish Initial Intake Packet

• Spanish-Brief Injury History
• Spanish-Informed Consent Contract
• Spanish Release of Records
• Spanish Review of Systems