Patient Forms
All patients please fill out the 4 forms listed below:
Please fill out the following form(s) as they apply to your symptoms or diagnosis.
- Back Index - please fill out if you have back or referred leg symptoms.
- Neck Index - please fill out if you have neck or referred arm symptoms.
- The Lower Extremity Functional Scale - please fill out if you have knee, ankle or foot symptoms.
- Disabilities of the Arm, Shoulder and Hand - please fill out if you have arm, shoulder or hand symptoms.














