New Patient Paperwork Packet
All new patients need to complete these forms. You can save time at your first appointment by using these computer fillable forms that you can fillout. Then print, sign and bring with you on your first appointment. DO NOT EMAIL.
Patient Prescription Form
In the state of Texas, we need a Doctor's referral to treat a patient. Please print this form and bring it to your Doctor to sign, to be referred for Physical Therapy treatments. You can then, bring it with you on your first appointment or drop it off before the first visit.
Upper Extremity Initial
This questionnaire asks about your symptoms as well as your ability to perform certain activities. Please print, complete and bring to your appointment.
Lower Extremity Initial
Are you are having any difficulty at all with the activities listed below because of your lower limb problem. Print and complete for your appointment.
This form will help identify difficulties you may be experiencing because of your dizziness or unsteadiness. Print, complete and bring the form to your appointment.
This questionnaire will give your provider information about how your neck condition affects your everyday life. Please print and complete before your appointment.
This survey is meant to help us obtain information from our patients regarding their current levels of discomfort and capability. Please print, complete and bring to your appointment.
Cupping and Dry Needling Consent Form
Please print this form. Then read the description, sign, date, and print name. Bring with you to your appointment.
Dry Needling Medical History form
You can complete this form on your computer, print, sign and bring to your appointment.