Patient Forms
All therapy services require a physician’s referral. If you would like to come to Total Rehab, feel free to print the form below to take to your doctor.
Save time in our office by completing the new patient form prior to your visit. Please complete, print and bring with you on your first appointment:
Harlingen Clinic
595 Sesame Dr. West
Harlingen, TX 78550
Phone: (956) 428-5440 
Fax: (956) 428-3375   



Brownsville Clinic
1300 Wild Rose Ln
Brownsville, TX 78521
Phone: (956) 542-2845
Fax: (956) 548-9019
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