Canadian is my roots, I'm Dr. Steven Zielinski, a Montreal native now practicing in the United States, dedicated to providing top-tier spine care to Canadians. Combining Canadian understanding with cutting-edge American technology, eliminating long wait times for patients. Graduated from Lower Canada College, earned my medical degree at McGill, completed neurosurgical residency at the Montreal Neurological Institute, and a Fellowship at Stanford. My roots are in Montreal, my parents still live in the same home I grew up in. Have family in Ottawa, Mississauga, and Kelowna. I've
Patient Paperwork
New patient paperwork refers to the forms and documents that a patient needs to fill out when they visit a healthcare provider for the first time. These forms typically gather important information that helps the provider understand the patient’s medical history, current health, and insurance details. Also in this form are Consent Forms: Consent to treat, consent for release of medical information, and acknowledgment of office policies (e.g., privacy practices, billing procedures). Financial Agreement: Acknowledgment of payment responsibility, co-pays, or payment plans. HIPAA Authorization: A form that complies with the Health Insurance Portability and Accountability Act, allowing the provider to protect and use your medical information.
These are some of the following other information:
- Satellite Clinic locations of Texas Spine and Neurosurgery
- Conservative treatments that you have tried
- Pain diagram
- Neurosurgical history
- Chief complaints
- Review of body systems
- Allergies and medications
- Pharmacy
- Social History including tobacco and alcohol use
- Surgical history
Help us personalize your care under Dr. Zielinski by filling out the file linked below. For inquiries or to schedule an appointment you may contact us.
Please click here to download the new patient paperwork.
Once downloaded, print it and fill out the form. Please bring the completed paperwork together with any imaging discs and printed radiology reports on your appointment day.
If unable to download the new patient paperwork, please come to the clinic at least one (1) hour after the clinic opens and at least one (1) hour before your scheduled appointment time to fill it out. Once done, then that’s the time that you will be seen and checked by Dr. Zielinski.
This paperwork helps the Dr. Zielinski to create a detailed record for you, ensuring he offers an appropriate care based on the your specific needs.