Forms & documents

To expedite the registration process, please fill out the following forms associated with the issue for which you are seeking treatment. 

Please note: these forms are editable, meaning you can type in your answers, save the the document, and then print out the edited documents and bring them with you on your first visit. Some documents will require signatures and scores that can be addressed during your visit.

All New Patients:

Notice of Privacy Practices

Consent Form

Registration Form

Patient Health Questionnaire

Choose from the following based on the issue for which you are seeking treatment

Neck Index

Back Index

Upper Extremity Functional Index (shoulder, hand, etc.) 

Lower Extremity Functional Index (knee, foot, etc.) 

Vestibular and Balance Subjective Questionnaire

Dizziness Handicap Inventory - Screening Version (DHI-S) 

If none of the above apply to your issue, please fill out: 

Optimal Instrument Difficulty

If you are 65 or older

Fall Risk Assessment

If you were not referred

Patient Attestation Form