Laser Spine Institute Patient Forms

Registration Forms

Complete and return Registration Forms prior to your visit at Laser Spine Institute. Please bring the original copy to your appointment.

Patient Registration Form Download

Patient Authorization to Obtain Medical Information (RIS)

Laser Spine Institute can obtain your MRI records for you. Many imaging providers require that the patient sign a release to provide permission for us to obtain the records. Please sign and return this completed form to your Spine Care Consultant. Obtaining Medical Records Instructional Download

Permission to Verbally Discuss Health Information

If you would like your family or loved ones to be informed about your health information, you may provide permission with this written form. Please complete and return this form to your Spine Care Consultant or provide verbal permission while speaking with a Laser Spine Institute team member. Permission to Verbally Discuss Health Info Download

Patient Authorization to Release Medical Information

After your surgery has been completed, you may request your medical records. Please allow a minimum of two weeks from the date of your surgery for your record to be transcribed and completed before sending your request. Authorization for Release Health Info Download