Prepare for your upcoming appointment with ease

Streamline your experience by printing and completing the following office forms prior to your visit at The Spine Institute Center for Spinal Restoration. The following forms are available for download in Acrobat PDF format for your convenience.

Appointment Preparation Checklist

This checklist includes all of the items you need to bring with you for a hassle-free appointment experience. Read the list carefully and bring as much of the requested items as possible.

New Patient Information

Fill out the New Patient Information Form in its entirety so The Spine Institute staff can better assist you during your appointment. We ask that this is done prior to arriving at our office.

Workman’s Compensation Patient Registration

Complete this form if you are visiting The Spine Institute Center for Spinal Restoration about a back or neck injury that occurred while on the job and you need to register for Workman’s Compensation.

HIPPA Notice of Privacy Practices

This notice describes how health information about you (as a patient of The Spine Institute Center for Spinal Restoration) may be used and disclosed, and how you can get access to your individually identifiable health information.

Medical Records Request

If you need to request medical records, please print this form which authorizes the disclosure and/or use of your health information as set by California and Federal law.


Santa Monica
2811 Wilshire Blvd, Suite 850 Santa Monica, CA 90403.
(310) 828-7757
Beverly Hills
444 San Vicente Blvd 901 Los Angeles, CA 90048.
(310) 248-7340

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