Client Forms

Download, print, fill-out and bring to your appointment!

In order to get you checked in quickly when you arrive, our forms are available here!

Please download and print the appropriate form below. Fill it out and bring it with you to your first visit. If you have any questions, please contact us at 503-885-8677.

pdfdownloadlogoHealth History Questionnaire
This form is just for your first visit.

pdfdownloadlogoWomen’s Health Questionnaire
This form is for women who need help with women’s issues

pdfdownloadlogo    Pelvic Health Consent Form
This form is for women

What Software Do I Use to Open the Forms?
Once downloaded, these forms should open easily on your computer already. If not, please download and install the free Acrobat Reader onto your computer.

pdfdownloadlogoLower Extremity Functional Scale (LEFS)
This form is people dealing with leg pain or problems

pdfdownloadlogoOswestry Neck Pain
This form is for people with neck pain

pdfdownloadlogoOswestry Low Back Pain
This form is people with pain in their lower back

pdfdownloadlogoQuick – Disability of the Arm, Shoulder, and Hand (Q-DASH)
This form is for people with arm, shoulder, and hand problems

pdfdownloadlogoPelvic Floor Distress Inventory (20)
If you are experiencing urinary incontinence, rectal incontinence or pelvic organ prolapse

pdfdownloadlogoVulvar Pain Questionnaire
If you are experiencing genital pain

What Software Do I Use to Open the Forms?
Once downloaded, these forms should open easily on your computer already. If not, please download and install the free Acrobat Reader onto your computer.

Healing Injuries. Eliminating Pain. Preventing Surgeries. Loving Incredible Results!

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Rather than hook you to a machine and leave you for the duration of your appointment, you’ll experience a significantly different, and caring approach here. Our clients rave about it.