Intake Forms

Please print one Insurance Coverage form, No-Show Policy form, and HIPAA Privacy Policy form, sign, and bring to you first appointment.

  • Click here to access the Insurance Coverage form, print it out, sign it, and bring in for your initial examination.

  • Click here to access our No-Show Policy, print and sign it, then bring it to your initial examination.

  • Click here to read the K-13 HIPAA Privacy Policy

    Click here to access the acknowledgement form

Functional Scales

  • Fill out this form for arm, elbow, hand, or shoulder pain.

    Click here to print your Upper Extremity functional scale.

  • Fill out this form for ankle, knee, hip, or leg pain.

    Click here to print your Lower Extremity functional scale.

  • Fill out this form for neck pain.

    Click here to print your Neck Disability index.

  • Fill out this form for back pain.

    Click here to print your Low Back questionarre.