All new patients must fill out the appropriate paperwork
prior to their Initial Evaluation(IE) visit:

1) All Patients must fill out a Patient Information Record

2) All Medicare Patients must fill out a Short Form McGill Pain Questionnaire form

3) All Patients must fill out the form related to the part of the body that they are seeking treatment for

a. Neck/Cervical Pain – Neck Disability Index form

b. Upper Back, Arm, Shoulder or Hand Pain – Disabilities of the Arm, Shoulder, Hand (DASH) form

c. Low Back/Lumbar Pain – Oswestry Disability Index form

d. Leg Pain – Lower Extremity Functional (LEFS) Scale

e. Lymphedema (Swelling) Arm – Disabilities of the Arm, Shoulder, Hand (DASH) form

f. Lymphedema (Swelling) Leg – Lower Extremity Functional (LEFS) Scale

g. Physical Therapy following Mastectomy/Reconstruction – Disabilities of the Arm, Shoulder, Hand (DASH) form