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FRIUS
Make a Referral

p. 214.351.6600 | f. 214.351.6453
MON thru FRI — 8am - 4:30pm
AUSTIN — DALLAS — FORT WORTH

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New Patient Forms

Download & Complete Patient Forms

Be sure to:
  1. Complete all forms
  2. Sign all notices
  3. Bring the completed forms with you to your first appointment
Patient Forms:
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  • PDF iconEnglish – Non Work Comp
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For More Information: p: 214.351.6600 | f: 214.351.6453
Hours of Operation: Monday through Friday 8am ‑ 4:30 pm
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AUSTIN — DALLAS — FORT WORTH

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Close Menu
  • Home
  • About
    • History & Vision
    • Staff
    • Performance Indicators
    • Historical Outcomes
    • Awards & Accreditations
    • Ethics
  • Services
    • Conditions and Diagnoses Treated at FRIUS
    • Functional Restoration Program
    • Physical / Occupational Therapy
    • Psychological Support and Counseling
    • Biofeedback and Self-Regulation Training
    • Medical Case Management
    • Medication Management
    • Additional Medical Services
  • Patients
    • Functional Restoration: What to Expect
    • FRIUS Patient Demographics
    • Performance Indicators
    • Success Stories
    • New Patient Forms
    • Request Your Health Records
    • Contact Disciplinary & Licensing Boards
  • Medical Professionals
    • Research
    • Questionnaires
    • Insurance and Billing
    • Make a Referral
  • Contact/Locations
  • Blog