Online Forms


Lawrence Teixeira DC, PA. offers our patient form(s) online so they can be completed it in the convenience of your own home or office.  Let us help you get back to life!

  • If you do not already have AdobeReader® 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 appointment.

New Patient Forms - Required (Vehicle Accident form will also be needed if related to a car accident)

This lets us know the history and current state of your health. It also includes our financial policy.  What questions, concerns, or goals can we help you with? Let us know!

Download & Print Form

Vehicle Accident Form - Required only if your injury is related to a car accident

This form allows us to better understand how your accident happened and how that releates to your injuries.

Download & Print Form

Download the Free AdobeReader®

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