Patient Forms

PTOSI Patient getting treatment

Please arrive to your first appointment 15 minutes early for check in and insurance verification.

Medical Form: Backpdf logo

Medical Form: Neckpdf logo

Medical Form: Historypdf logo

This form should becompleted by all patients, new and returning, for your first therapy appointment. Please print, fill out, and bring with you to your first appointment.

HIPAA Privacy Notice Formpdf logo

This form describes how health insurance information about you, as a patient of this practice, may be used and disclosed. This is required by the Privacy Regulations. Please print, sign and bring with you to your first therapy appointment.