Patient Forms

For your convenience, we've put our patient forms on our website. Please download, print and complete the forms. Then, bring them with you on your first visit to expedite matters.

1. Patient Registration Form
2. HIPAA Signature Form
3. HIPAA Notice of Privacy Practices
4. Medical Screening Form - for TMJ patients only
5. Neck, Head, Thoracic Spine, Ribs Intake Survey
6. Low Back Intake Survey
7. Shoulder Intake Survey
8. Arm and Hand Intake Survey
9. Foot, Ankle, Lower Leg Intake Survey
10. Hip, Pelvis, Upper Leg Intake Survey
11. Knee Intake Survey
12. Generic Intake Survey
13. Neurological Intake Survey
14. TMJ Disability Index
15. Oswestry Disability Index
16. Massage Therapy Health Form
17. Massage Therapy Release Form

[Printable Version]