FIRST VISIT
Pre-Treatment Forms
Which forms do I need?
| Patient Intake Form | All patients need this form | |
All patients need this form All patients need this form For your information Please sign this form after reading the Patient Privacy Policy All patients need this form |
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| Medicare Questionnaire | If you have Medicare Insurance or a replacement policy | |
| QuickDASH | If your diagnosis is for arm, shoulder or hand | |
| Oswestry Low Back Questionnaire | If your diagnosis is for low back, lumbar, sacrum, pelvis, sciatica | |
| Neck Disability Index | If your diagnosis is for neck pain | |
| Lower Extremity Functional Scale | If your diagnosis is for knee, meniscus, collateral ligament, patella, quad, calf, hip area, ankle sprain, plantar faciitis, Achilles tendonitis or bursitis | |
