Patient Information

List of Current Medications: Include all prescription and over-the-counter medications, vitamins, and supplements. Note the dosage and frequency for each.

Previous Medical Records: Bring any relevant medical records, including:

• Imaging Studies: X-rays, MRIs, CT scans, bone scans, etc.
• Electrodiagnostic Tests: EMG, nerve conduction studies.
• Laboratory Results: Blood tests, urinalysis, and others

Treatment History: Provide a summary of past treatments related to your condition, such as:

• Physical Therapy (dates and duration).
• Medications previously prescribed (names, dosages, treatment periods).
• Injections or procedures received (type and date).

Referral Information: If referred by another healthcare provider, bring their name, contact information, and any referral notes.

Pre-Visit Forms

Questionnaire forms may be sent to you via email to complete before your first appointment.

Please complete and submit them electronically or bring printed copies with you.

If you do not receive these forms, please call the office to confirm.

Patient Registration and Questionnaire

For Lower Extremity Evaluations:

If you are being evaluated for a knee, hip, or leg condition, wear or bring shorts to allow for a proper examination.

For Upper Extremity Evaluations:

Wear a sleeveless or short-sleeved shirt if the complaint involves the shoulder, elbow, or arm.

Insurance Cards:

Bring your current insurance card(s).

Identification:

A government-issued photo ID (e.g., driver’s license, passport) is required.

You may bring a family member or friend to:

• Assist with providing additional medical history.
• Help take notes during the appointment.
• Support with transportation or mobility if needed.

Symptom Diary:

Record when your symptoms began, how they have changed over time, and any activities that worsen or improve them.

Questions and Concerns:

Prepare a list of questions you would like to discuss during your visit.

Healthcare Providers List:

Bring names and contact details of any other doctors or specialists you currently see.

Preferred Pharmacy:

Provide your preferred pharmacy’s name and contact information.

Arrival Time:

Please arrive at least 15 minutes early to allow time for check-in and document review.

Cancellation Policy:

If you are unable to attend, please provide at least 24 hours’ notice to avoid any cancellation fees.

Coming prepared helps us deliver better care and minimizes delays.

We look forward to seeing you at your appointment!