Completing your forms before your appointment saves time and helps us begin your care immediately. You may also fill out forms at our office on arrival — our front desk team is happy to assist you.
Patient Intake Forms
New Patient Registration
Complete your personal information, emergency contacts, and primary care provider details before your first visit.
Required for all new patientsMedical History Form
Provide your complete medical history, current medications, allergies, and prior treatment history related to your accident.
Speeds up your evaluationInsurance Authorization
Authorize Accident Care to bill your auto insurance, health insurance, or attorney's office directly on your behalf.
Required for insurance billingHIPAA Consent & Privacy Notice
Review and acknowledge our privacy practices for handling your protected health information as required by federal law.
Required by federal lawAccident Information Form
Document the details of your accident including date, location, vehicles involved, and how the injury occurred.
Supports your insurance claimAttorney Lien Authorization
If you are represented by a personal injury attorney, authorize treatment on a lien basis so there is no upfront cost.
Optional — for attorney-referred patientsBring to Your Appointment
- Government-issued ID or driver's license
- Auto insurance card
- Health insurance card (if applicable)
- Attorney's contact information (if represented)
- Any prior medical records related to your accident
If you have questions about which forms apply to your situation, call our office at (405) 842-3209. Walk-ins are welcome — same-day appointments available.