Forms | dtwellness

Healthcare professional assisting patient

Patient Intake Forms

New patients are welcome to fill out required paperwork below and bring in on your first visit and begin your Physical Therapy Evaluation / Treatment right away!

All forms are in Adobe PDF format. If you need to download the Adobe Acrobat plugin, please click here.

Patient Agreement Form
Patient Data Form
New Patient History Form
Physician Referral Form
Pain Scale Form
Patient Privacy HIPPA Awareness Form
Consent of Care & Treatment Form
Patient Credit Card Signature Form
New Patient Fax Cover Form