FAQ/Info: Patient Forms
All forms are saved in PDF format, and are compatible with all PDF file viewers. If you have an issue with any of these files, please contact us for more information.
Patient In-take Forms
Please print and fill out these forms, and make sure to bring them with you on the day of your visit.
Patient Insurance Forms
Download HMSA Injury Wellness Form
Download Notice of Exclusions from Medicare Benefits
Physical Therapy Forms
Download Physical Therapy Privacy Notice
Consent Forms
Please print and fill out these forms, and make sure to bring them with you on the day of your visit.
Download Massage Therapy Consent/Release Form
Download Wiki Wiki & Beyond Rx Consent/Release Form
Agreements
Please print and fill out these forms, and make sure to bring them with you on the day of your visit.
Download Privacy Policy Agreement Form
Quality Assurance Survey / Patient Results
Download Physical Therapy Patient Results Form
Download Physical Therapy Quality Assurance Survey
Special Circumstances
Download Authorization to Disclose Medical Information
Download ID Theft Complaint/Affidavit