CENTRAL TEXAS NEUROLOGY CONSULTANTS (512)218-1222
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    • Administrative Team
    • Clinical Team
    • Physical Therapy Team
    • News and Announcements >
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  • Our Providers
    • Craig H. Couch, MD
    • Adam D. Horvit, MD
    • Elizabeth L. Peckham, DO
    • Terry S. Peery, DO
    • Yashma R. Patel, MD
    • Parisa Khosravi, DO
    • Breanna Purdie, MSN, APRN, FNP-C
    • Karan Saini, PA
  • Services
    • Headache Center
    • Center for Sleep Medicine
    • Multiple Sclerosis Clinic
    • Epilepsy Center
    • Neuromuscular Center
    • Movement Disorder Center
    • Electrodiagnostic Center (EMG and EEG)
    • Infusion Center
    • Physical Therapy >
      • Physical Therapy Forms
  • Patient Resources
    • New Patient Scheduling
    • Patient Forms >
      • Dr. Couch Patient Forms
      • Dr. Patel / Dr. Khosravi Patient Forms
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      • Dr. Peery Patient Forms
    • Research >
      • Clinical Trial Enrollment Form
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    • Location
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    • Our Privacy Policy
  • Contact
  • Pay My Bill Online
  • Patient Portal
  • Home
  • About Us
    • Our Mission
    • Administrative Team
    • Clinical Team
    • Physical Therapy Team
    • News and Announcements >
      • Office Closures
      • MS Walk 2025
    • What's a Neurologist?
  • Our Providers
    • Craig H. Couch, MD
    • Adam D. Horvit, MD
    • Elizabeth L. Peckham, DO
    • Terry S. Peery, DO
    • Yashma R. Patel, MD
    • Parisa Khosravi, DO
    • Breanna Purdie, MSN, APRN, FNP-C
    • Karan Saini, PA
  • Services
    • Headache Center
    • Center for Sleep Medicine
    • Multiple Sclerosis Clinic
    • Epilepsy Center
    • Neuromuscular Center
    • Movement Disorder Center
    • Electrodiagnostic Center (EMG and EEG)
    • Infusion Center
    • Physical Therapy >
      • Physical Therapy Forms
  • Patient Resources
    • New Patient Scheduling
    • Patient Forms >
      • Dr. Couch Patient Forms
      • Dr. Patel / Dr. Khosravi Patient Forms
      • Dr. Horvit Patient Forms
      • Dr. Peckham Patient Forms
      • Dr. Peery Patient Forms
    • Research >
      • Clinical Trial Enrollment Form
    • Billing Information
    • Insurance Information
    • Location
    • Pay My Bill Online
    • Additional Resources
    • Our Privacy Policy
  • Contact
  • Pay My Bill Online
  • Patient Portal
Dr. Couch Patient forms
New Patient Packet
General Neurology Health Questionnaire

New Patient Arrival Time | ​30 minutes before your appointment time with paperwork completed

Follow up Patients Arrival Time | 15 minutes prior to your appointment
16040 Park Valley Dr, Building B, Suite 100 | Round Rock, TX 78681 | Phone (512)218-1222 | Fax (512)218-1393
Central Texas Neurology Consultants, PA  ©2023
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