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| Please fill out the forms below and bring them along with your prescription for Therapy to your first appointment. New Patient Registration Form (All Patients) Medical History Form (All Patients) PT (Lower Extremity and Spine) AM-PAC Form (Medicare Patients Only) OT(Upper Extremity) AM-PAC Form (Medicare Patients Only) |
| Serving West Texas since 1961 |
| DORA ROBERTS REHABILITATION CENTER |
| Thank you for choosing Dora Roberts Rehabilitation Center. |
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| PHONE: 432-267-3806 FAX: 432-267-3809 306 West 3rd Street, Big Spring, Texas 79720 |