Patient Forms
Because we are dedicated to providing you the best physical therapy solutions, we are now making our patient forms available online for downloading and printing. Below are the links to all of the forms that are required prior to your appointment as well as a few other forms/documents. Simply click on the link, print the form using your printer, and fill in the appropriate information, and you're on your way to an even more convenient appointment.
NOTE: To view these forms, you will need Adobe Reader. If you do not have Adobe Reader, you can click on the red and white Adobe Reader button to download the program. Or, if you don't see the button click this link > Get Adobe Reader.
New Patient Required Forms/Documents
- Financial/Consent to Treat Policy
(A statement of our Financial/Consent to Treat Policy, which we require you to read and sign prior to treatment.) - Intake Form
(A form you will use to describe your pains/problems.) - Notice of Privacy Practices
(This notice describes how medical information about you may be used and disclosed and how you can get access to this information.) - Summary Notice/Written Acknowledgement of Receipt
(This form is your acknowledgement that you have received our written Notice of Privacy Practices for protected health information. You must first print out the above document before filling out this form.)
Other Forms/Documents
- Patient Satisfaction Survey
(If you are a current or former patient, please take a moment to share your experience on this survey. You can mail in or drop this form off at your local Orthopedic & Spine Therapy clinic.) - Medical Record Release to OST
(Authorization for release of information TO OST.) - Medical Record Release to PATIENT or OTHER FACILITY/AGENCY
(Authorization for release of information TO PATIENT or OTHER FACILITY or AGENCY.)