Pre-Registration Forms

Our therapists are interested in ensuring that you, our customer, are receiving the most successful therapy services possible. To allow us to measure and compare our rehabilitation outcomes for specific diagnosis or injuries, we also ask you to fill out an outcome study questionnaire specific to your injury, illness or diagnosis.

If you are being seen for...

• A hip or leg injury or surgery please print and complete the Lower Extremity Functional Scale.
• If your injury is to your lower back, please print and complete the Low Back Pain Questionnaire Outcome Survey.
• An injury to your shoulder, arm, wrist or hand, please print and complete the Disability of the Arm, Shoulder and Hand Outcome Survey.
• Neck pain, injury or surgery please print and complete the Neck Disability Index.

Printing and completing these forms in advance of your appointment will save you significant time in our clinic waiting room and will allow you to more quickly and easily complete final registration and see your therapist for your full scheduled treatment appointment when you arrive.

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