Patient Forms

New patients should attempt to arrive 10 – 15 minutes prior to your first appointment time to complete patient registration forms. To save time, you may download the forms from our website and complete them prior to your appointment. Wear comfortable clothes which will allow ease of movement during exercise such as: sweat pants, shorts, tee shirt and sneakers or rubber soled shoes. We will provide gowns for patients being treated for neck and back conditions. What to bring on your first appointment:

• Insurance card
• Picture id
• Prescription from your referring physician, nurse practitioner, physician’s assistant, chiropractor, or dentist.
• Referral if your insurance requires one

Telehealth Starter Guide

Your telehealth appointment and what to expect:

• Telehealth Guide

New Patient Registration Forms

All patients please download and fill out the forms below:

• Patient Forms
• Telehealth Consent Form
• For your information, no signature required

Orthopedic Patients please select your appropriate form below:

• Low Back Pain form: Oswestry & STarT Back Screening Tool
• Neck Pain form: Oswestry
• Hip, Gait and Balance: Hip Outcome Survey
• Knee Form: Knee Outcome Survey
• Foot and Ankle Pain: Foot and Ankle Disability Index Score
• Shoulder Pain: PENN Shoulder Score
• Elbow, Wrist and Hand Pain: QuickDash

Vertigo and Dizziness:

• Dizziness Handicap Inventory & Questionnaire

Golf Rehabilitation and Sports Training Programs:

• Sports Performance and Training Packet
• Golf Rehabilitation-Golf Fit Golf Strong Training Program Packet

Women’s Pelvic Pain and Urinary Problems:

• Women’s Health Forms

Men’s Pelvic Pain and Urinary Problems:

• Men’s Health Forms