Integrity

New Patients

New Patient Registration

You can download, print, complete, and bring the forms below to your first appointment. Otherwise, plan to arrive 30 minutes before your appointment to complete registration forms.

  1. New Patient Registration
  2. Service Agreement IR
  3. Policy Cancelled or Missed Appointments
  4. Patient Intake Form
  5. New Pediatric Patient Registration

Pelvic Floor Rehab Patient Registration

The forms below include daily bladder and bowel records to be completed for 3 days BEFORE your first appointment. You can download, print, complete, and bring the forms below to your first appointment. If you are unable to print the forms, please call us as soon as possible at (254) 699-3933 and we will mail them all to you.

  1. Introduction Letter
  2. Pelvic Floor History
  3. Pediatric Health History and Screening Questions
  4. Keeping a Record of Bowel and Bladder Function
  5. Informed Consent
  6. General Health Questionnaire
  7. Bristol Stool Scale
  8. Pelvic Pain Questionnaire