What you can expect

Our goal is to provide you with superior service every time your interact with us.

For your convenience we provide the forms you will need online. Our office will instruct you as to which forms you will need.

Feel free to fill out these forms in advance by printing out the form and bring it with you or fill out online HERE and they will be transmitted to us securely.

Please note

On your first appointment with us, please bring:

  1. The Physical Therapy Referral / Rx from your doctor
  2. Photo ID (example: Driver’s license)
  3. All Insurance Cards so we can make copies
  4. A list of all current medications and vitamins including dosage, frequency, and administration route.(we have these form online HERE for your convenience).

Feel free to call us if you have any questions or need help with directions.

New Patient Forms

New Patient Registration/Insurance

Download Printable Form Here

Patient Medication List

Download Printable Form Here

New Patient History Form

Download Printable Form Here

Balance/Vestibular Patient Survey Forms

Activities-Specific- Balance-Confidence Form

Download Printable Form Here

Visual Analog Scale

Download Printable Form Here

Dizziness Handicap Assessment Form

Download Printable Form Here

Falls Efficacy Scale

Download Printable Form Here