Forms
All patients should open, print and fill out the:
Please show up 15 minutes early for your scheduled time!
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)