NPT CENTERS
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    • Psychology & Neuropsychology
    • Audiology
    • Physical Therapy
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    • Mild TBI / Cioncusstion Testing
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Image of X ray, NCV waveform, brain with outline of face, head and neck, Neurology and Physical Therapy Centers of Tampa Bay


New patients only, please complete the following:

1. Click below and Complete the New Patient Questionnaire.
New Patient Questionnaire Button - call 813-831-6622 if you need help completing

​2. Click below to sign legal documentation - for all doctors' appointments except Expert, IME, CME &Psychology.
New Patient Signature Forms -  call 813-831-6622 if you need help completing

​​3. Click below to sign legal documentation for all neurological, audiological and diagnostic Expert Evaluations, IME's, and CME's
CME, Expert, & IME Signature Forms - call 813-831-6622 if you need help completing

​4. Please complete the following form with how you are feeling ​currently:
Pain Body Sheet & Disability Index - call 813-831-6622 if you need help completing

​5. Click below to sign legal documentation for Psychology, with Dr. Shelley Tindell-Nodine
Psychology Signature Forms -  call 813-831-6622 if you need help completing

​6. Click below to sign authorization for psychological treatment of a minor child, if applicable:
Psychology Authorization for the treatment of a minor child - call 813-831-6622 if you need help completing

7.  For all Compulsory, Expert, and Independent Psychological Evaluations, Examinee must sign the following: 
Psychology Expert, CME & IME Signature Forms - please call 813-8310-6622 if you need help completing


13.  For all Washington State Patients, please sign the following Telemedicine Consent Form:  
Washington Telemedicine Appointment Consent Form

14. Please read the Notice of Privacy Practices at your convenience.
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Neurology and Physical Therapy Centers of Tampa Bay
Tampa, FL

813-831-6622
2835 W. De Leon St.
Suite 205
​Tampa, FL  33609

Location

address

2835 W De Leon St
Suite 205
Tampa, FL 33609



contact us

Please call Monday through Friday 8:00A.M. - 4:00 P.M.
Phone: (813) 831-6622

Fax: (813) 874-1936

​[email protected]
  • Home
    • Neurology
    • Psychology & Neuropsychology
    • Audiology
    • Physical Therapy
    • Headache Treatment for Acciddents
    • Mild TBI / Cioncusstion Testing
  • Our staff
  • Insurance
    • Workers Compensation Services
    • Expert Services
  • Directions
  • Patient Forms