Patient Intake Forms

A young girl standing on a medical scale with a black weight on her head, and a woman checking her chest during a medical examination.

Prepare for Your Visit

To be ready for your visit, we suggest the following:

  • Print and complete the intake forms found below.

  • Obtain and bring a copy of your latest x-ray. Often, the X-ray is provided to you on a disc from the doctor’s or radiologist’s office.

  • We collect payment at the time of treatment.  If you have out-of-network benefits through BCBS/Horizon, Aetna or United Health Care we are able to submit to your insurance as a courtesy.  To do this, we will need a copy of the front and back of your insurance card.   For other insurances, we will provide you with a superbill which you can submit to your insurance.

  • Check out the Insurance Information page on this website for helpful information relating to insurance reimbursement.

  • Pictures will be taken to document progress.  

  • Wear sports clothing. A sports bra is recommended for females. (We need to see your back.)

  • You may want to bring a water bottle with you to stay hydrated.

An elderly woman assisting a young boy with a vertical hanging exercise on a wooden wall bar in a gym or therapy room.
A woman is doing a stretching exercise with resistance bands attached to a wall-mounted wooden exercise frame, while a healthcare professional is examining her lower back.