The following forms must be completed by all new patients prior to your first visit.
(Forms will open in a new window. To access them, please ensure your pop-up blocker is disabled.)
- Informed Consent - Electronic HIPAA, consent to treat, and payment policy form required for all new patients.
- Patient Intake - Electronic patient intake forms for all new patients.
- Medical History - Electronic medical history information for all new patients.
Please also print and fill out the form that pertains to the area we are treating if listed below:
- Upper Extremities - Arm/Shoulder/Hand
- Lower Back
- Lower Extremities - Hip/Knee/Foot
- Dizziness Handicap Inventory
- Falls Efficacy Scale
Medicare Patients - please fill out one additional form