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 the Deferred Payment Agreement.
​7. Click below to sign authorization for psychological treatment of a minor child, if applicable:
8.  For all Compulsory, Expert, and Independent Psychological Evaluations, Examinee must sign the following: 
9. Immediately following your visit, please sign the Disclosure Form below (for Florida Auto Accidents):  
10. If you are being referred for nerve conduction testing (NCV/EMG) only, please complete the following form: ​
11  For all Washington State Patients, please sign the following Telemedicine Consent Form:  
12. 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