Intake Forms

Would you like to save yourself 20 minutes during your first visit to my office? The following forms are available online for your convenience.

~ Please click on the following link: INITIAL INTAKE FORM

Please print and fill out this form. The file contains 5 pages that will ask you general, as well as, health history questions, which when filled out ahead of time will save you at least 15 minutes during your first visit

~ Is your Chief Complaint neck pain? Please click the following link: NECK QUESTIONNAIRE

~ Is your Chief Complaint back pain? Please click the following link: BACK QUESTIONNAIRE

Please print and fill out the form or forms that apply to you. These questionnaires have been designed to give the doctor information as to how your back and/or neck pain is affecting your ability to manage everyday life. They are also used as an outcome measure and you will be asked to fill one out again at a subsequent follow-up visit to measure the efficacy of your prescribed treatment plan. When filled out ahead of time, this will save you an additional 5 minutes during your first visit.