New Patient Packet
Complete your paperwork before your visit so we can spend the appointment focused on you — not forms.
Your privacy comes first
Everything you type or upload stays inside your browser until you finish the form and email it to us. Nothing is transmitted to our website servers.
At the end, you'll download a PDF and email it to info@triumphorthospine.com — which is monitored on our HIPAA-covered Google Workspace.
15 minutes
Most patients finish in a single sitting. Progress saves automatically to your device.
Before you start
Have your photo ID, insurance card (if applicable), and a list of medications ready.
Mobile-friendly
Works on your phone. Snap photos of your ID and insurance card right from your camera.
Triumph accepts most major insurance plans
We accept payment from all major insurers.
Where we do not participate in-network with your plan, we will work directly with your insurer to help you receive coverage.
You can use our second opinion service without going through your insurer.
By starting, you acknowledge you've read our Privacy Policy and HIPAA Notice of Privacy Practices.
Need help?
Call us at 1-877-215-PAIN (7246) or fax completed forms to (877) 706-1872. Prefer paper? Ask at check-in and we'll hand you the same form on a clipboard.