Before you get started, there are a few important things you need to know:

• THIS IS NOT AN EMERGENCY TREATMENT SITE. If you need immediate help CALL 911 or your emergency medical provider or go to an Emergency Room NOW.
• This website and this method of communication is used for delivery of non-emergency purposes and is not monitored in real time.
• You are completing this preassessment form as a prospective patient.
• You understand that completing this pre-assessment form does not create a patient or therapeutic relationship with The Hopper Group and will not guarantee an appointment if you are not accepted as a patient by The Hopper Group.
• This form contains questions about your protected health information. By completing this form, you acknowledge that you are voluntarily providing the information requested to The Hopper Group, and that you have read and understand The Hopper Group's Notice of Privacy Practices.
• To ensure an effective evaluation of your case, you agree to provide complete and accurate responses to the best of your knowledge. Be honest, as all information is confidential and is used in compliance with HIPAA patient privacy requirements.
• Our Online Appointment Request Process is the preferred, expedited method for new patient appointment inquires. A staff member will review your information and contact you within two (2) to five (5) business days. If you are unable to complete this form online, contact us at 817.274.8800, and a staff member will assist.