Download Your Forms Here

The following two forms are required for new patients and must be filled out PRIOR to coming to our office for your first appointment. The remaining forms will be required based on your reason for your initial visit. Our office will inform you of the required paperwork for your initial visit.

For your convenience, please complete forms below. Email completed form to memorialcity@houstonrt.com or bellaire@houstonrt.com, or bring in 15 minutes before your appointment time

New Regenerative Patient Form:

Health Insurance/Self Pay Form:

What to Expect at Your Initial Visit

We want to make sure your first visit is a great experience. Your needs and concerns are our top priority, so we ensure you have all the paperwork you need to bring readily available.

For your convenience, please complete the New Patient Forms prior to your appointment. This will save you 10 to 15 minutes and allow you to complete the forms in the comfort of your own home.

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Step1 Consultation

We review your history and answer any questions or concerns.

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Step 2 Evaluation & Testing

Our evaluation & Testing  will be performed to determine where the level of your lesion is and if other problems are contributing to your condition. Our testing evaluation will help us determine what modalities are needed to maximize your recovery and protect your investment. And foremost we need to first determine if you are a good candidate for our program of care.

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Step 3 Review X-Ray’s

Your radiographs and MRI studies will be reviewed or new x-rays may be ordered if needed to allow us to clearly determine a proper care plan for your needs,.. These X-rays/MRIs are will help us identify key areas of your body for treatment. Radiographs will also give us insight into any poor habits you may have developed over the years of ignoring your symptoms.

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Step 4 Report of Findings

Your findings will be given to you, after the consultation, examination and a sample trial on one of our modalities. We ask that you bring the person closest to you during your evaluation.  You may invite anyone in your family to accompany you if you so choose. Your report of findings includes a detailed analysis of the necessary treatments to solve the problem that brought you to our office, as well as necessary preventative measures for the future.

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Step 5 Ongoing

Our report will list out what cutting edge modalities and services you are going to receive during your follow up care and explain why we picked them and what they will do for youIn addition, we will always keep any time to a bare minimum, so that ongoing treatments do not interfere with your busy schedule.

- Houston Regenerative Therapy
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