Patient Forms

The following forms will assist us in ensuring the best course of treatment for your illness, injury or condition. Please click on the banner below to download the forms. If you do not have access to a printer, you may complete them when you arrive for your appointment. (You will need to arrive 20 minutes EARLY if you need to complete the forms in the clinic.)

Our forms are PDF files. To download and print the forms, you’ll need the free Adobe Acrobat Reader program.

Physical Therapy Patient Forms

1. Download and complete the Patient Intake Packet (auto-fill form)
2. Then, download and complete the form for the area(s) or condition(s) we are treating:
   • Neck (auto-fill form)
   • Back (auto-fill form)
   • Upper Extremity (auto-fill form)
   • Lower Extremity (auto-fill form)
   • Dizziness (auto-fill form)

   • Balance (auto-fill form)
   • Concussion Screening Form (auto-fill form)
   • Post Concussion
   • Pelvic Health (auto-fill form)
3. Download and complete the Release of Information Form (auto-fill form)
4. Download and read the Notice of Privacy Practices (for your records)

Massage Therapy Forms

• New patients, please download and complete the Massage Therapy Forms - New Patients (auto-fill form)
• Existing patients, please download and complete the Massage Therapy Forms - Existing Patients (auto-fill form)