Patient Resources

Prior to your physical therapy evaluation, please complete the Intake Paperwork and bring it with you to your appointment. (All paperwork is available in the clinic. Please arrive 10-15 minutes early to complete.)

Patient Forms

Functional Survey

Every patient will fill out one of the following functional surveys based on the body part being treated.

Hand, elbow or shoulder 

Hip, knee or foot/ankle 

Neck or upper spine 

Lower or middle spine

Patients with Regence Insurance:

Regence Incident Report

Patients with Premera Insurance:

Premera Incident Questionnaire 

Optional:

The benefits worksheet is a guide for you when calling your insurance company and asking about your physical therapy benefits. As a courtesy, our team does a benefits check prior to your first appointment, but we encourage every patient to educate themselves on their coverage. Any quote provided by the insurance company is not a guarantee of payment, and any fees accrued that the insurance company does not pay will be your responsibility.

Benefits Worksheet