We are ready to get started serving you and your rehabilitation needs. Before we get going, we need information on the patient. Patient, medical and insurance information needs to be gathered so we can serve and treat you in the best way possible.
You will find a patient form below that you can fill out online. If you would rather download, print, and fill out the form via PDF download, you will find it under the fillable form. If you choose to do the latter, please scan it back in and upload it via the “Upload File” option under the form. If you are unable to scan to your computer, you can bring these forms with you to the office.
Please Note: The “New Patient” form has four total sections. As you will see, most of the form fields are required. Please fill out the form in its entirety before submitting.
* If there are errors in your submission, there will be a (red) error message telling you what needs correcting.
Please watch this video for information on insurance deductibles:
Our waiting room is restricted to PATIENTS ONLY – those who require assistance, as well as minors, can have one person enter the building with them. Other family members and guests are asked to please stay outside or in your vehicle.
We are doing our best to create the safest and cleanest environment for you to receive your care. Our facility is professionally cleaned on a weekly basis. All of our equipment and treatment tables are cleaned constantly throughout the day.