As a new patient referred to our physical or hand therapy center, you are required to fill out a few forms. For your convenience we have organized them below. Please print out and complete all the appropriate forms and bring them along to your first appointment.

Read the Privacy Policy

Please sign the Consent to Treat Form and the
Acknowledgement of Receipt of Notice of Privacy Practices for Protected Health Information

Please fill out and sign Patient Intake Form

Please fill out the form that applies to your diagnosis:

• If you have a lower back problem: Lumbar Spine Functional Questionaire
• If you have a neck problem: Cervical Spine Functional Questionaire
• If you have a hand, wrist, elbow, or shoulder problem: Upper Extremity Functional Questionaire
• If you have a foot, ankle, knee, or hip problem: Lower Extremity Functional Questionaire

Thank you for choosing OAL.