What to Bring to Your Appointment
If you are a new patient, please arrive 1 hour early to complete paperwork. However, if you have completed the form below, it is only necessary to arrive fifteen minutes before your scheduled appointment.
On the day of your appointment, we will also need the following information:
New Patient Form - Online
To complete your new patient form online, please click the button below. You will be directed to our secure, online form.
New Patient Online Form
New Patient Form - Download & Print
To download and print your new patient form, please click the button below. Please remember to bring your completed form with you to your appointment.
New Patient Download & Print
Payment Options
Segura Neuroscience & Pain Center accepts most insurance plans, but patients should always check with their individual carriers to determine our participation with their plans.