New Patient Forms

FIDEL INTEGRATED MEDICAL SOLUTIONS offers our patient form(s) online so
they can be completed it in the convenience of your own home or office.

  • If you do not already have Adobe Reader® 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

(1) New Patient Health History Form – Required

This lets us know the history and current state of your health. What questions,
concerns, goals, regarding wellness can we help you with? Let us know!

Download & Print Form

(2) Neck and Low Back Questionnaires – Required

This lets us know the current state of disability due to your neck and/or
low back pain.

Download & Print Form

(3) Motor Vehicle Accident Form

This form can be printed out and filled out prior to coming in so you don’t
have to wait and possibly forget any important details about the accident.

Download & Print Form

Download the Free Adobe Reader®

Let’s Get Started

Email us to request your next appointment.