New Patient Forms

We only treat workers comp and personal injuries. We specialize in these fields. Personal Injuries can be anything from a car accident, to a motorcycle accident or a slip and fall, where there is a third party liability. Third party liability means that someone else is responsible financially for your pain and suffering.

Below you will find our forms that must be filled out to be seen as a new patient. Every new patient will fill out these forms to be seen. The links below are the forms that you can print off, complete and bring with you to your appointment, saving you time at the first appointment.

Bring in your printed and completed forms to our Milwaukee facility so that we may get started right away treating your pain. The following forms and useful documents are in Adobe Acrobat; they require the free Acrobat Reader to view. Click on each to download, print and view.

New Patient Form
Auto Accidents Form
Workers Comp form

Here at Accident and Injury Rehab Center You Come First

Here at Accident and Injury Rehab Center You Come First

Contact Info

info@injuryrehabcenters.com

(414) 643-9000
6114 W. Capitol Dr.
Milwaukee,Wisconsin 53216

Questions? Drop us a line

Contact Info

info@injuryrehabcenters.com
(414) 643-9000
6114 W. Capitol Dr.
Milwaukee,Wisconsin 53216

Questions? Drop us a line