Patient Forms

Download and print these out to expedite your first visit.

If you're bringing your completed forms to a first visit, please call and let us know, so we can schedule your first visit accordingly.

Clinic Privacy Policy
Consent to Treatment / Financial Policy
Patient Confidential Information
Patient Health History

Additional Forms (based on your current complaint)

NDI Questionnaire - For neck pain
Oswestry Questionnaire - For back pain
Upper Extremity Functional Scale - For arm and shoulder complaints
Lower Extremity Functional Scale - For hip and leg complaints
Fibromyalgia Impact Questionnaire - For fibromyalgia sufferers
Quadruple Visual Analog Scale - For any kind of pain
Headache Disability Index - For all types of headache