New Client Forms
Please complete the following forms prior to your physical therapy appointment (download pdf’s):
▼New Client Intake with Insurance Info 2018
▼ Current Medical History Form
▼ Current Policies & Procedures
Forms for patients according to diagnosis
If you are seeing the physical therapist for low back pain, please complete the following forms:
If you are seeing the physical therapist for neck pain, please complete the following form:
▼ NDI (The Neck Disability Index)
If you are seeing the physical therapist for knee pain, please complete the following form:
▼ KOS (Knee Outcome Survey)
If you are seeing the physical therapist for shoulder, elbow, or wrist pain, please complete the following form:
▼ DASH (Disabilities of the Arm Shoulder or Hand)
If you are seeing the physical therapist for leg, ankle or foot pain, please complete the following form:
▼ LEFS (The Lower Extremity Functional Scale)
All Medicare Clients will need to fill out the following form as well:
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