CLIENT PAPERWORK

Physical Therapy Clients

No two client situations are the same. A full and complete description of your current complaint and how you got here is extremely important to ensure that your treatment is safe and appropriate for you. Thank you for taking the time to follow the steps below and provide these details in advance of your initial appointment!

• Electronically fill out, sign, and submit our client self-assessment & intake (works best from a computer; please allow 15-45 seconds for the page to fully load). If you prefer to download the form instead, you may do so here.
  • If you are unsure if your form was successfully submitted, please contact us to confirm by either sending a text with the green “Text” button at the bottom-right of this screen or calling us at (360) 752-2673.
• Please review our financial policies and HIPAA disclosure. Paper copies are also available upon check-in.

Additional forms that may be needed depending on your insurance or the condition for which you are being seen:

• If you have been in an automobile accident: Complete, sign and bring this PIP Waiver with you to your first appointment.
• If Medicare is your primary insurance: We are required to verify a complete record of your current medications. If you do not already have a comprehensive list, you may wish to use the following form provided by AARP:
  • Medication Record (PDF)
  • Medication Record (MS WORD)
• For our pelvic health & continence clients:
  • Daily Voiding Log with instructions for completing a record of bowel or bladder function.
  • Vulvar Pain Questionnaire

Personal Training Clients

Thank you for following the steps below so your personal training program can be designed specifically for you, to ensure it meets your body’s needs and is tailored to your individual goals.

• Please click here to complete your intake packet in advance of your session.
• Please review our financial policies and HIPAA disclosure. Paper copies are also available upon check-in.