If you wish to fill out new patient forms prior to visiting the office, please download and print PDF files here:
1. Patient Demographics: Patient Demographics
2. Intake Symptoms Form: Intake Symptoms
3. Intake History Form: Intake History
4. Medication list: Documentation of Current Medications
5. Cancellation Policy: Cancellation Policy
6. HIPPA Acknowledgement: HIPAA Acknowledgement
* If your injury was from an accident (Labor & Industries or a Motor Vehicle Accident), please fill out this accident form: Accident Information
Then select the Functional Index closest to the body part being treated:
- Low Back Index: Low Back Index
- Neck Index: Neck Index
- Shoulder Index (2 pages): Shoulder Index
- Lower Extremity Index: Lower Extremity Functional Index
Notice of Privacy Practices (HIPAA)
***READ ONLY** Do Not Print, unless you would like for your own records:
Please Arrive at least 10 min before your scheduled appointment time and bring with you the above completed paperwork, referral from your doctor and any test results (MRI, X-Ray) you may have.
*** If you are not filling out the paperwork ahead of time, please arrive in our office at least 20 minutes before your scheduled appointment time.***
Thank you! We look forward to meeting you!