Online Forms

New Patient Health History Form - Required

This lets us know the history and current state of your health. What questions, concerns, goals, regarding wellness can we help you with? Let us know!

  • If you do not already have AdobeReader® installed on your computer, click here to download.
  • Download the necessary form(s), print it out and fill in the required information.
  • Fax us your printed and completed form(s) or bring it with you to your appointment.

Self Pay Paperwork Download & Print Form

Insurance Paperwork Download & Print Form

United Healthcare (ACN/Optum) Specialty Forms

*Not required for all UHC plans. Please verify with our office manager to see if your plan requires this additional paperwork.

Patient Summary Download & Print Form

Neck Index Download & Print Form

Back Index Download & Print Form

Disabilities of the Arm, Shoulder and Hand (DASH) Download & Print Form

Lower Extremity Functional Scale (LEFS) Download & Print Form

Medicare Paperwork Download & Print Form

Motor Vehicle Accident Paperwork Download & Print Form

Personal Injury Paperwork Download & Print Form