New Patient Paperwork

Twin Cities Headache Neck & Back offers our patient form(s) online so they can be completed in the convenience of your own home or office.

  • Some forms are PDF files. You will need AdobeReader® to view them.
  • If you do not already have AdobeReader® installed on your computer,
    Click Here to download.
  • Download the necessary form(s), print them out and fill in the required information.
  • Bring the necessary form(s) to your appointment.
  • ONLINE Secure Intake Paperwork

    NOTE: The Intake Paperwork can only be filled out on a computer or iPad that supports mouse or touch features for signatures.

  • Patient Referral Form

    Click to Download

  • HIPAA Form

    Click to Download

Insurance information

At Twin Cities Headache Neck & Back we are committed to making our care affordable for just about anyone. We gladly accept most health insurance. To learn more about our insurance information CLICK HERE.


8:30am - 12:00pm
2:00pm - 6:00pm


8:30am - 12:00pm
2:00pm - 6:00pm

2:00pm - 6:00pm

8:30am - 12:00pm

Saturday & Sunday

Twin Cities Headache Neck & Back

245 Ruth St N #205
St Paul, MN 55119
P: (651) 925-5530
F: (651) 493-1980