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New Patient Intake Forms

PLEASE CLICK BELOW FOR THE APPROPRIATE FORM, PRINT THE FORM AND FILL IT OUT. BE SURE TO BRING THIS WITH YOU TO YOUR FIRST APPOINTMENT.

PATIENT INTAKE PACKET
FUNCTIONAL RATING INDEX
PAIN SCALE FORM
BACK INDEX
DASH
Dizziness Handicap Inventory
Foot and Ankle Outcome Score
Hip Outcome Score
Knee Injury and Joint Replacement
Lower Extremity Functional Scale
Neck Index
Low Back Disability
Post Concussion Symptom Scale
Quick Dash
SPADI
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  • 6236 South Pinnacle Place, Suite 106,  Sioux Falls, SD 57108   (605) 215-8890