New Patient Forms » Physical Therapy

Please complete the following paperwork prior to your first appointment. Fill out the Medicare questionnaire ONLY if you have Medicare. Please complete only the pain questionnaires that are applicable to your injury/condition.

You may download a printer-friendly version by clicking on PDF next to the forms, or request that we mail the forms directly to you when you schedule your first appointment. Please bring the completed paperwork with you and arrive 15 minutes prior to your appointment time to allow enough time to complete your registration.

Required Forms:

• New Patient Form (PDF)
• Physical Therapy Intake Form (PDF)
• Medicare Questionnaire (PDF)

Pain Questionnaires:

• Back Pain (PDF)
• Neck Pain (PDF)
• Shoulder Pain (PDF)
• Lower Extremity Pain (PDF)