Patient Forms | Chronic Pain Patients | The Spero Clinic

New Patients

Fill out the New Patient form after you reserve a date for The Spero Clinic’s 14 Week Neurologic Rehabilitation program.

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Website & Social Media Personal Release Form

Please fill out and submit this form online.

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Treatment Qualification Contract

Please fill out and submit this form online.

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Pediatric Treatment Qualification Contract

Please fill out and submit this form online.

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Legal Guardian/ Decision Making Form

This form must be signed, notarized, and returned to us via email to [email protected]. The file will automatically be downloaded to your computer when you click the button.

Contraindications

Please fill out and submit this form online.

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Release of Liability, Assumption of Risk, and Indemnity Agreement

Please fill out and submit this form online.

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Patient Privacy Rights

Please fill out and submit this form online.
Password: SperoClinic1!

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Start your patient journey with the Spero Clinic's neurologic rehabilitation program.

Have questions first? Call us! (479) 304-8202

CRPS treatment clinic patient Bria with dr.katinka

(479) 304-8202

Spero Clinic