WELCOME NEW PATIENTS
Find Important Documents For Your First Visit With Our Therapists
Save time for both you and your therapist by filling out these important forms ahead of your appointment.
Consent for Outpatient Therapy Treatment
Patient Questionnare/Health History
Intake
Form
PT HIPAA
Consent


Physical Therapy Forms
 

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Lower Extremity Functional Scale
Back Index
Neck Index
DASH
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Upper
 Extremity Functional Scale
Rolland-Morris Low-back and Disability
Shoulder Pain and Disability
Index
Dizziness Handicap Inventory
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Oswestry Hip Pain Disability Index
Lymphedema Life Impact Scale
Knee Outcome Survery ADL
Knee injury and Osteoarthritis Outcome Score
Click Here
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Consent for Outpatient Therapy Treatment


Occupational

Therapy Forms
 

Patient Questionnare/Health History
Intake
Form
OT HIPAA
Consent
Click Here
Click Here
Click Here
Click Here
Upper
 Extremity Functional Scale
DASH
Pelvic Floor Questionnaire
Patient Pelvic Questionnaire
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Click Here
Click Here
Click Here
Your First Visit
For your first visit to PRN Physical and Occupational Therapy, please arrive at least 15 minutes before your scheduled appointment so that you have time to register with the receptionist. The receptionist will ask you to complete a registration form in order to establish your medical record and obtain your current insurance information. We ask that you bring your current insurance card(s) with you to this visit and all subsequent visits, as well as your co-payment, if applicable.

During subsequent visits, please check in at the reception desk, so your information can be reviewed for accuracy. You can help us serve you better by notifying the receptionist or doctor’s office of any changes in name, address, telephone number or insurance coverage since the time of your last visit. Reporting changes of personal information will ensure that you receive the most appropriate medical care, and also ensure that the services you received are covered by your insurance company.