New Patient History Form

Please be sure to click the Submit button once completed.

Guidelines for out of town patients are here: 

More information for new patients can be found here.

  • Describe the pain: its location, its strength from 1-10 and how long you have had it.
  • Please e-mail current Xrays to [email protected]

    We request current Xrays so Dr. O can evaluate how best to set up your first appointment. If current ones are unavailable, we will take new ones. Please send all relevant imaging.

    Date Format: MM slash DD slash YYYY
  • Has the treatment been done? Has there been any difficulties or complications with past treatment? This will help us to understand your unique needs and your situation.