Get a head start on your personal therapy plan.

The more we know about you, the better we can custom-tailor a therapy plan for your personal needs and goals. So please take a few minutes to print and fill out two of these forms and bring them with you to your appointment.

The New Patient Intake Form is for all patients. It tells us about your overall medical history and the general nature of your pain.

The Questionnaires each relate to a specific problem area – the Back, the Neck, the Arm, Shoulder and Hand, or the Lower Extremities. They tell us more about the specific functional problems related to your injury or condition.

If you’re not sure about which questionnaire best applies to you, just arrive a few minutes early and we’ll give you the proper one.

If you ‘d rather complete the paperwork when you get here, we do ask that you arrive 20 minutes early to ensure your appointment can begin on time.

Patient Intake Form

Back Form

Neck Form

Arms/Shoulder/Hand Form

Lower Extremities Form