Patient Forms
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Patient Forms

Dr. Counce is a board-certified Neurologist and Board Certified Neuroradiologist
Click on the Patient Portal link to:
  • Exchange messages with our practice
  • Review and pay billing statements
  • Request appointments
  • Research health topics
  • Review personal health information
  • Complete and update medical forms
  • Update your profile and contact information
Patient Portal
New patients, please download and fill out the forms below before your initial visit.
File
Privacy Practices

File
Medical Record Release

File
Test Patient Questionnaire

File
Non-Headache Questionnaire

File
Headache/Migraine Questionnaire

Call Us Today At ♦ (205) 536-8736

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