Forms for your first visit

Please download and fill out the Health Intake, Treatment Authorization and appropriate Outcome Measure forms prior to your scheduled visit. If you would prefer to complete the forms in our office, please arrive 15 minutes prior to your first appointment.

Health Intake Form

View/Download
Health Intake Form

Treatment Authorization/ Medical Release

View/Download
Treatment Authorization/ Medical Release

Privacy Practice Policy

View/Download
Privacy Practice Policy

OUTCOME MEASURE FORMS

Choose the most appropriate outcome measure:

Neck

View/Download
Neck

Arm/Shoulder/Hand

View/Download
Arm/Shoulder/Hand

Leg

View/Download
Leg

Back

View/Download
Back

Dizziness

View/Download
Dizziness
We Look Forward to Meeting You!

Typically, you can get started without a physician referral (except for Medicare and Medicaid)! Call Deidra to set up your first appointment and to discuss insurance specifics