forms

Welcome to Creekside Physical Therapy

Before you begin physical therapy there are various forms that you will need to fill out.  They are available here for you to print and fill out at your convenience.  Or, if you prefer, we can mail them or fax them to you at your request.  Please bring the completed forms with you when you come for your first session at Creekside.

If you are unable to obtain the forms before your first session, please come in 15-20 minutes before your appointment to allow sufficient time to fill out the forms.  If you have any questions about these forms, we will be happy to help you.

Medical History — Please complete, including the medication list.  If you have a list of medications already written up or from your medical clinic, bring a copy of that with you. New Registration Form — Please read and sign or initial where appropriate.
Privacy Practices — Please read, this is for your information.

 

 

Cancel/No Show — Please read.

 

 

 

Minnesota Standard Consent Form for Releasing Health InformationPlease click, for additional information. Referral/Treatment Plan

 

There are some forms that may be specific to your condition or insurance. These may also be filled out ahead of time. If you are not sure which ones may apply to you, you can wait until your appointment to fill them out or we can send them to you.

Medicare Medication List TMJ Functional Assessment