new: Policies and Procedures due to Covid-19 (ALL PATIENTS)

Please PRINT and SIGN this form prior to your appt.

1. Patient Demographics & Medical history

Please PRINT and FILL OUT this form prior to your appt.

2. fees and CANCELLATION POLICY

Please PRINT and FILL OUT this form prior to your appt.

Your appointment time is reserved exclusively for you. For this reason we maintain a 48hr cancellation policy.  If you cancel or don't show for an appointment without providing at least 48 hours advance notice, you will be charged the appointment fee.  No further appointment will be scheduled until the cancellation charge has been paid in full.  

We consider your time to be just as valuable as ours. We respect appointment times and will not keep you waiting to see the therapist.

3. FUNCTIONAL dry needling consent foRM

Please PRINT and FILL OUT if requested by Physical Therapist.