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Instructions: Please view the documents below and choose the area in which you are injured. Please click on the file, print out the documents, fill them out and bring them with you along with your physical therapy prescription, insurance cards and driver's license to your first treatment.

Forms

Arm (shoulder, elbow, wrist, hand)

Back

Back and Leg

Leg (hip, knee, ankle, foot)

Neck

Neck and Arm

Neck and Back

 

Functional Outcome Tools

Lower Extremity Functional Scale

Disabilities of the Arm, Shoulder, and Hand

Oswestry Disability Questionnaire

Neck Disability Index Questionnaire

 

20451 Tamiami Trail South, Unit 6    Estero, Florida 33928      Phone: (239) 948-2222      Fax: (239) 948-2225

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