Forms                  

All patients should open, print and fill out the:

Please show up 15 minutes early for your scheduled time!

• Financial Agreement - merged
• Medical history
• Patient Info sheet
• Privacy Practice
• DOWNLOAD ALL FORMS

Out of those, if you are seeing us for a hip, thigh, hamstring, knee, calf, shin or ankle/foot, then fill out the LEFS.pdf  / (Spanish Ver.)
 

For the shoulder, upper arm, lower arm or hand, fill out the: DASH.pdf / (Spanish Ver.)

For the back, fill out the Back Index.pdf / (Spanish Ver.) and for the Neck, fill out the Neck Index.pdf / (Spanish Ver.)

United health care patients need to fill out the:
ACN Health Questionnaire / (Spanish Ver.)

If they are having a functional capacity evaluation:
Then all FCE forms.

Functional Capacity Evaluation Info (if you are scheduled for an FCE)