Please download, print and complete the necessary forms prior to arriving at your first visit
New Patient Intake Form: Private Insurance Only or Self Pay
New Patient Intake Form: Workers Compensation or No-Fault (Car Accident)
Must Be Filled Out Also:
HIPPA Consent Form For Privacy Practice
Pre Exam Form
Must Be Filled Out: Functional Disability Index Required by all Insurance Companies:
Oswestry Disability: For Back Pain
Neck Index: For Cervical Pain
Lower Extremity Functional Scale: For Ankle; Knee; Hip
Dash: For Shoulder; Elbow; Wrist; Hand
Dizziness Index: For Balance and Vertigo
If you have any questions, please review our Frequently Asked Questions, send us an email or call our office (718) 855-1543.
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