Intake & Consent Forms

If you prefer to fill forms out by hand or fillable pdf rather than online (via onpatient portal), please see the forms below. You can fax (512-850-6963), mail (1313 Ranch Road 620 S #203, Lakeway, Texas 78734) or email (join@laketravisintegrative.com) prior to your appointment.

Fillable PDF forms:

• Fillable pdf: MSQ
• Fillable pdf: Adult Intake Form
• Fillable pdf: consent forms
• Fillable pdf: Records Release Authorization (ROI)
• Fillable PDF: Pediatric Intake Form 

Printable forms (please fax, email, or mail after completion):

• Adult Intake Form
• Pediatric Intake Form
• Consent Forms LTIM
• Medicare Opt Out Agreement Consent Form
• Medical Symptoms Questionnaire (MSQ) Intake Form