Patient Forms - Cerebrum Health Centers
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New Patient Forms

Before your appointment, please download and complete our new patient forms. If you are a civilian seeking treatment, please complete the New Patient Demographics and History Form AND the Metabolic-Neurologic Assessment Form. If you are a civilian seeking diagnostics (but not yet treatment), please complete the New Patient, Diagnostics ONLY Form. If you are a military personnel or veteran, fill out the Veteran Intake Form.

These forms can be filled out and signed on your computer. Once you finish filling out the forms, please email them directly to your point of contact. Completed patient forms must be received prior to your entrance date. Thank you and we look forward to seeing you!

New Patient Demographics
and History Form

Assessment Form

New Patient,
Diagnostics ONLY Form

Veteran Intake

Medical Records
Release Form

Request More Information About Cerebrum Health Centers Today