Get Tx Nobilis Health New Patient Intake Form 2018-2025

Filling out the TX Nobilis Health New Patient Intake Form online is a crucial step in ensuring you receive the proper care. This guide will help you navigate the form step-by-step, making the process straightforward and manageable.

Follow the steps to complete your new patient intake form easily.

1. Click ‘Get Form’ button to access the form and open it in your preferred editor.
2. Provide the date in the designated field to help organize your submission timeline.
3. Enter your Social Security number (SS#) accurately to ensure correct identification.
4. Select your preferred time for an appointment by marking the appropriate option.
5. Indicate whether a C-ARM is required by selecting 'Yes' or 'No' in the provided checkbox.
6. Specify the C-ARM size by selecting either 'Large' or 'Small' as per your needs.
7. If applicable, fill out any special equipment or vendor information relevant to your case.
8. Select your admission status by marking either 'Inpatient,' 'Outpatient,' or '23 Hour Observation' as required.
9. Indicate if you are utilizing bariatric benefits by selecting 'Yes' or 'No.'
10. Confirm if surgery clearance by hospitalist has been obtained by marking the relevant option.
11. Indicate whether pre-admission testing at the hospital has been performed and attach orders if applicable.
12. Include the required documents by checking the corresponding boxes for the demographic sheet, insurance card, driver's license, surgical orders, and medical records pertinent to pre-certification.
13. Once completed, save changes to your form, then download or print it for submission.
14. Submit all documents via the specified website or email address provided on the form.

Complete your TX Nobilis Health New Patient Intake Form online today for efficient processing and care.