New Patient Intake Form2020-09-08T15:32:04+00:00

New Patient Intake

To fill out the New Patient Intake Forms, please select the city location of your local Transcend office and your preferred language. Once your selections are made, please click submit to be redirected to Docusign, where you will fill out the forms electronically.

You will be prompted to fill out every required field and will not be able to submit the form until all required fields are completed. If you click submit and are redirected to the top of the forms, that means a required field has been left blank.

At the bottom of the form, there is a section to attach a photo of your insurance card. To ensure promptness in verifying your information, we strongly suggest that you include a photo of your insurance card with this form. If you have questions, please contact your local Transcend office.