Forms available for printing are listed on the right.

New Patients:

• Please print the Patient Intake Form, Consent Form and Daily Task Self-Assessment Form and fill them out to bring to your evaluation.  Your therapist will review this information and answer questions during your first session. 
• The Notice of Privacy Practices contains more detailed information about our Patient Privacy and HIPAA Policies.  HIPAA is an acronym for the "Health Insurance Portability and Accountability Act" enacted by the U.S. Congress in 1996, which addresses the use and disclosure of an individual's health information. Please print or save a copy for your records.
• If you have trouble printing or completing the forms prior to your evaluation, please arrive 15 minutes early to allow time for form completion at the clinic
• For your first visit, please dress in loose, comfortable clothing, and bring your insurance cards, driver's license, completed forms and any medication lists.  If you have access to X-Ray, MRI or similar reports related to your diagnosis, please bring them with you for your therapist to review.

Prospective Patients and Physicians:

• Please print the Referral Form for your physician to complete.  The physician's office can simply fax the form directly to our office (239) 395-5857.  This form also contains a list of services we provide.