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OWCP / DOL–enrolled medical practice · Las Vegas & North Las Vegas
NuTheraInjury Recovery & Wellness
Intake

New patient forms.

Complete your intake forms before your first appointment. It saves time at check-in and lets our clinicians review your history in advance.

Your privacy is protected. All intake forms are processed through our HIPAA-compliant system under a signed Business Associate Agreement.

General Medical Intake

Required for all new patients. Demographics, medical history, medications, allergies, and reason for visit.

15 – 20 minutes

OWCP Federal Workers' Compensation Intake

Additional form for federal employees with active OWCP claims. Includes claim number, CA-1/CA-2 details, authorization letters, and injury history specific to your work injury.

Complete in addition to General Medical Intake

DOL Injury Recovery Intake

For patients with DOL-covered work injuries not filed under OWCP. Captures injury mechanism, work duties, and current restrictions.

Complete in addition to General Medical Intake

Consent to Treatment & Financial Responsibility

Standard acknowledgment of treatment and billing policies. You'll also sign this at your first visit.

2 – 3 minutes

How you'll receive your forms

Once you request an appointment, our team will email you secure links to the forms appropriate for your visit type. Forms are completed through our HIPAA-compliant portal — please do not email or fax forms with PHI unless directed by our staff.