United Healthcare requires different patient forms. If your insurance is through United Healthcare, these are the forms you need to fill out. Please print the forms, fill the forms out completely and bring them to your first office visit.

You will need to fill out two separate forms.

1. All patients with United Healthcare insurance must fill out the Patient Health Questionnaire.

Download Patient Health Questionnaire
(ALL UNITED HEALTHCARE PATIENTS)

2. You will also need to fill out a form based on your particular injury — back, neck, lower extremity, or arm/shoulder/hand. In addition to the Patient Health Questionnaire, please only fill out the form that applies to your particular injury.

Back Injury (download this form)

Neck Injury (download this form)

Lower Extremity Injury (download this form)

Arm/Shoulder/Hand Injury (download this form)