Peak Performance Physical Therapy offers our patient form(s) online so they can be completed in the convenience of your own home or office.
- If you do not already have AdobeReader® installed on your computer, click here to download.
- Download the necessary form(s), print it out and fill in the required information.
- Fax us your printed and completed form(s) or bring it with you to your appointment.
This lets us know the history and current state of your health. What questions, concerns, goals, regarding wellness can we help you with? Let us know!
New Patient Intake - Download & Print
Select a form based on your area of complaint
Lower Back Disability Questionnaire - Download & Print
Lower Extremity Functional Scale - Download & Print
Neck Disability Questionnaire - Download & Print
Wellness Questionnaire - Download & Print
Upper Extremity Questionnaire - Download & Print
Request for Physical Therapy Referral Form - Download & Print