Helpful Forms

The following forms are designed to help us work together more easily:

Health History

Please print, fill out, and bring to your first appointment.

Depression Assessment

Please fill out this form if you'd like to discuss your melancholy. (Doesn't necessarily need to go in your record.)

Headache Disability Index

Please fill out this form if you've been experiencing headaches.

Disability measure of the Arm, Shoulder, and Hand

Please fill out this form if you're experiencing arm, shoulder, or hand issues.

Neck Index (UHC)

Please fill out this form if you're experiencing neck issues

Back Index (UHC)

Please fill out this form if you're experiencing back issues

Lower Extremity Functional Scale

Please fill out this form if you're experiencing hip, leg, knee, ankle, or foot issues..

KOOS Knee Survey

Please fill out this form if you're experiencing knee pain.

*Patient Specific Functional Scale

Please bring this form to our first meeting and think about what three activities are being impacted by your symptoms.

Intended Outcomes Form

This form will help you clarify your goals for your overall health and vitality, including our time together.

Note: To download Adobe Acrobat Reader for free, click here.