For our new Patients we have made a resource center to speed up the process and wait time during your first appointment. Please take a moment to download the forms below prior to your first visit to our office. If you are an existing Patient you may find useful resources below. Please review our services to determine if there is a questionaire that corresponds and needs to be filled out prior to your next office visit.

 You may upload your completed paperwork through our website or email the completed documents to info@limalubbock.com or use our secure fax at 806-722-3185.

Patient Forms are all listed below and begin with LIMA - there are (4) documents in our new patient paperwork process, please let us know if you have any questions!

Credit Card Authorization Credit Card Authorization (449 KB)

Fibromyalgia Questionnaire Fibromyalgia Questionnaire (220 KB)

IBS Questionnaire IBS Questionnaire (541 KB)

Infertility Questionnaire - Men Infertility Questionnaire - Men (597 KB)

Infertility Questionnaire - Women Infertility Questionnaire - Women (458 KB)

Ketamine Disclosure Ketamine Disclosure (112 KB)

Ketamine Patient Registration and History Ketamine Patient Registration and History (520 KB)

Ketamine Procedure Consent Ketamine Procedure Consent (119 KB)

Medical Records Release Medical Records Release (45 KB)

Menopause Questionnaire Menopause Questionnaire (237 KB)

New Patient Consent Form New Patient Consent Form (36 KB)

New Patient History New Patient History (345 KB)

New Patient Registration Form New Patient Registration Form (52 KB)

New Patient Time-of-Service Payment Policy New Patient Time-of-Service Payment Policy (17 KB)

New Price List New Price List (145 KB)

PMS Questionnaire PMS Questionnaire (224 KB)

Prana Sample Report Prana Sample Report (4111 KB)

Prostatitis Questionnaire Prostatitis Questionnaire (313 KB)

Sleep Questionnaire Sleep Questionnaire (298 KB)

 


Contact our office to make your Appointment today!

You may email our office for your convenience, we will get back to you to set up your appointment and answer any questions!

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