It will speed up the patient intake process if you fill out any forms relating to your condition before your appointment. To make the process easier, please feel free to print and bring any forms to your first visit.
For all patients (can print and fill out or fill out on day of evaluation):
Patient Intake Form - Appropriate for all patients to fill out.
Medical Screening Form - Appropriate for all patients to fill out. This will assist your Physical Therapist in assessing your condition and providing the best possible care.
No Show Policy / Financial Policy - All patients must sign. We strive to have available scheduling options for all of your patients, and we want you to be aware of our policies if you miss appointments.
Personal Medication List - If you do not have a current list of medications, please feel free to update and bring with you. We will just need to document your current medications.
For some patients (please fill out ONE form that is most appropriate to your condition or body part involved):
Functional Scale Forms
Shoulder, Elbow, Wrist/Hand injury or pain - DASH (Disability of the Arm, Shoulder and Hand)
Low back injuries or pain - Modified Oswestry Scale (Low Back Pain and radiating pain)
Neck injuries or pain - Neck Disability Index (Neck and radiating pain)
Hip and Ankle injuries or pain - Lower Extremity Functional Scale
Knee injuries or pain - Knee Outcome Survey
Balance or history of falls - Falls Efficacy Scale or Activities Specific Balance Confidence Scale