New patients only, please complete the following:
1. Click below and Complete the New Patient Questionnaire.
2. Click below to sign legal documentation - for all doctors' appointments except Expert, IME, CME &Psychology.
3. Click below to sign legal documentation for all neurological, audiological and diagnostic Expert Evaluations, IME's, and CME's
4. Please complete the following form with how you are feeling currently:
5. Click below to sign legal documentation for Psychology, with Dr. Shelley Tindell-Nodine
6. Click below to sign authorization for psychological treatment of a minor child, if applicable:
7. For all Compulsory, Expert, and Independent Psychological Evaluations, Examinee must sign the following:
13. For all Washington State Patients, please sign the following Telemedicine Consent Form:
14. Please read the Notice of Privacy Practices at your convenience.
Neurology and Physical Therapy Centers of Tampa Bay
Tampa, FL
813-831-6622
2835 W. De Leon St.
Suite 205
Tampa, FL 33609
Tampa, FL
813-831-6622
2835 W. De Leon St.
Suite 205
Tampa, FL 33609