We make our forms available on-line to facilitate and expedite your visit to our offices.
Please click on the links below or on the left for additional instructions on the form and how and when to return it.
Release of Information (ROI) Forms
ESTABLISHED PATIENT: Transfer ARC Patient Records TO Non-ARC Physician
The Release of Information Form is required whenever you request that your medical records at ARC be transferred to a non-ARC doctor. The form requires your signature. Please follow the detailed instructions on the Release of Information page on our web site..
NEW PATIENT: Transfer Patient Records FROM Non-ARC Physician TO ARC Physician
For our new patient’s convenience, we also provide a release of information form to request the transfer of medical records from a non-ARC doctor to an ARC-doctor. If you are a new patient at Austin Regional Clinic and would like to transfer records from your non-ARC doctor to your ARC doctor, please use the Release of Information form below.
The Patient Registration process and subsequent form provides us with the information to set up your billing account with ARC. Information required includes demographics of each patient, responsible part for payment, and any health insurance information applicable to the patient. This form is required for all new patients to ARC, please refer to our Patient Registration link for additional information.
Pediatric Health History
If your child is a new patient at ARC, please complete the associated from under Pediatric Health History and give it to the doctor or nurse at the first visit. This form asks for information about the child's health, including major illnesses, immunizations, and injuries.
Adult Health History
If you are a new patient at ARC, please complete the Adult Health History Form and give it to the doctor or nurse at the first visit. This form asks for information about your health, including major illnesses, injuries, and surgeries, as well as family health history.
Patient Information and Consent of Minor
If you are the parent of a minor and would like your child to be seen by any of our providers without your presence, please fill out a Consent to Medical Treatment of a Minor form and have your child bring it to the appointment.
Medicare Wellness Visit Forms
If you are a Medicare patients and you have an appointment scheduled for a Medicare Wellness Visit, Medicare requires that you complete a new Medicare Wellness history form. We also provide advance directive forms that we recommend you fill out and keep on record with your ARC physician. Advance directives are legal documents that allow you to convey your decisions about end-of-life care ahead of time. They provide a way for you to communicate your wishes to family, friends and health care professionals, and to avoid confusion later on.
Patients will have to fill out physical therapy patients forms also available in en español below prior to the first physical therapy visit. Please bring these with you already completed or be prepared to arrive approximately 15 minutes before your scheduled appointment time.
Orthopedic Health History
Pain Medicine Patient Forms
For your convenience, and to help you save time during your appointment, please download and complete the Pain Medicine patient forms. Please bring these completed forms to your appointment or be prepared to arrive approximately 45 minutes before your scheduled appointment time to complete them before your appointment.