New Patient Questionnaires

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At the UCLA Health Spine Center, our experts diagnose, manage and treat all spinal injuries and conditions. Call 310-319-3475(Link opens phone app) to connect with a spine specialist.

Please click on your doctor's name for the appropriate patient form.

Please print the form and bring it filled out to your appointment. Do not mail in advance.

Allen Chen, MD, MPH(Link downloads document) (Link opens in new window)
Ulrich Batzdorf, MD(Link downloads document) (Link opens in new window)
Joel Beckett, MD(Link downloads document) (Link opens in new window)
David Fish, MD(Link downloads document) (Link opens in new window)
Langston Holly, MD(Link downloads document) (Link opens in new window)
Jae Jung, MD(Link downloads document) (Link opens in new window)
Elizabeth Lord, MD(Link downloads document) (Link opens in new window)
Daniel Lu, MD, PhD(Link downloads document) (Link opens in new window)
Don Park, MD(Link downloads document) (Link opens in new window)
Nick Shamie, MD(Link downloads document) (Link opens in new window)
Joseph Solberg, MD(Link downloads document) (Link opens in new window)
Andrew Vivas, MD(Link downloads document) (Link opens in new window)
Kyle Yang, MD(Link downloads document) (Link opens in new window)

New Patient Questionnaires

Find your care

Please click on your doctor's name for the appropriate patient form.

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