» Forms :
Forms

Physical Therapy in Colorado Springs











For all patients - Please bring a Photo I.D. or Military I.D., your insurance cards and, if available, any X-ray or MRI results. You can also print and fill out the New Patient Complete Packet before your first visit to streamline your registration process.


Here you can review our Notice of Privacy Practices


Medicare Only Questionnaires:

For Medicare patients who have an injury to their shoulder, arm, elbow, wrist or hand please fill out the

Upper Extremity Functional Index


For Medicare patients who have an injury to their neck region please fill out the

Neck Pain Questionnaire


For Medicare patients who have an injury to their hip, thigh, knee, shin, or ankle/foot please fill out the

Lower Extremity Functional Scale


For Medicare patients who have an injury to their low back please fill out the

Low Back Questionnaire