For first appointment please have all 3 completed

• Patient Intake sheet.pdf
• Medical history form.pdf
• Payment Policy.pdf

For first appointment please fill out the appropriate form that applies to your problem

• Lower Extremity Functional Scale.pdf (any problem with hip, leg or foot/ankle)
• Back Index.pdf (back pain and/or leg numbness/tingling)
• Neck Index.pdf (neck pain and/or arm numbness/tingling)
• Disability of Arm, Shoulder and Hand.pdf (any problem with shoulder, arms or hand)
• Dizziness Handicap Inventory. pdf (dizziness, balance or gait disorder)

“Thou madest him to have dominion over the works of thy hands; thou hast put all [things] under his feet:” ( Psalms 8:6  ESV)