Texas-Spine is the pre-eminent center in the world for Non-Traumatic Spine Surgery.
Contact Information:
Houston Phone Number 713-581-8666 : Houston Office opening in September
National Phone Number 800-956-6724

 

Contact Information:
Name   * Email   *
City State
Phone Number Zip Code
Medical Information:
Are you the Patient?    If no, please tell us Yes.       If no,
Areas of Difficulty
Has patient had spine surgery? Yes No
What was done? When was it?
Who was the surgeon?
Do you have Back Pain? Yes No   |    Leg Numbness?Yes No
Neck Pain?Yes No    |    Leg Weakness?Yes No
Patient's Age   |   Patient's Sex years old         Male Female
Please tell us your exact symptoms:
(back pain? leg pain? weakness? numbness? exactly where)
Describe patient's problem
The problem started when?
Has patient had a scan? What did it show?
Has patient seen a surgeon for a present problem? What was recommended?
What tests and treatment has patient had?
What would you like to ask us?
Other Information:
Insurance Company Name Type