Forms – New Patient Registration
Completing necessary forms in advance of your appointment will help you save time. They also help provide useful information to our therapists and improve your recovery and outcomes.
Please download and fill out forms completely before your first appointment. Please print completed forms and bring them to your first appointment.
Required Forms
New Patient Registration
It is not necessary to complete this form If you have completed intake information via WebPT.
Administrative Policy
It is not necessary to complete this form If you have completed intake information via WebPT.
Social Health / Misc. Health History
Please review and complete before your first appointment.
Consent for Treatment of Minor
Please complete if the patient is a minor, < 18 years old.
Additional Forms
Please only complete the forms below as directed by your Doctor of Physical Therapy
Cleveland Clinic Incontinence Score
Fear Avoidance Beliefs Questionnaire
HOOS JR
KOOS JR
NIHCPSI_Female
NIHCPSI_Male
Pain Catastrophizing Scale
Pain Disability Index
Patient Specific Functional Scale
Pelvic Floor Impact Questionnaire
Pelvic Girdle Questionnaire
Vulvar Pain Questionnaire
