New Patient Forms

Spinal Health & Rehab offers you the opportunity to fill out your new patient paperwork from the convenience of your own home.

*All NEW Patients please complete STEPS 1 & 2:*

*STEP #1 ONLINE*

ALL NEW PATIENTS please fill out your "HEALTH HISTORY" ONLINE FORM HERE (this will go directly into our system).

*STEP #2 PRINT & BRING WITH YOU *

New Patient  TO PRINT "NEW PATIENT INTAKE FORMS" PDF and bring it to your appointment with you.

*AUTO ACCIDENT / PERSONAL INJURY PATIENTS ONLY *

to PRINT if you are an AUTO ACCIDENT, AUTO INJURY, or PERSONAL INJURY PATIENT (Please fill out STEP #1 and #2 in addition to
this form)

The team at Spinal Health and Rehab is excited to meet you!

No printer, no problem just make sure to come at least 30 minutes prior to your appointment.


  • If you do not already have AdobeReader® installed on your computer, Click Here to download.
  • Download the necessary form(s), print it out and fill in the required information.
  • Fax us your printed and completed form(s) or bring it with you to your appointment.

Download the Free AdobeReader®

Location and Hours

324 Cross Street Punta Gorda, FL 33950, US

Monday  

8:00 am - 6:00 pm

Tuesday  

8:00 am - 6:00 pm

Wednesday  

8:00 am - 6:00 pm

Thursday  

8:00 am - 6:00 pm

Friday  

8:00 am - 6:00 pm

Saturday  

Closed

Sunday  

Closed