Patient Information and Forms

Appointments

To schedule an appointment, please call our office at (614) 586-1305. Someone will be happy to assist you.

Please make sure to bring the following items to your appointment: your insurance card(s) (or BWC card), your driver's license or State I.D., and comfortable clothing (shorts, sweats, gym shoes, etc.).

Patient Forms

Plan to arrive 10 - 15 minutes before your scheduled appointment time to fill out some paperwork. To save time, you may print the forms below on your own computer and then fill them out at home.

1. To get started, please download and print the patient intake forms from the following list:
   • Non-Medicare Patient Intake Forms
   • Medicare Patient Intake Forms
   • Patient Satisfaction Survey
   • Notice of Privacy Practices (for your records only)
2. Download and print the form that applies to the condition we are treating from the following list:
   • Neck
   • Upper Extremity
   • Back
   • Lower Extremity
3. Then bring the completed forms with you when you come in for your appointment.

Our forms are PDF files, which require the free Adobe Acrobat Reader program for viewing and printing.

[Printable Version]