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| Patient Info (download 148KB .pdf) |
| This form tells The Back Clinic more about your reasons for visiting. We ask you to describe your present problem and describe details of the pain. This form also asks for information on how the problem started. |
| Medical History (download 128KB .pdf) |
| The Back Clinic needs all patients to fill out a medical history form to better diagnose and treat you. These questions will guide the Therapists as they diagnose and treat your issues. |
| Neck Disability Index (download 136KB .pdf) |
| For patients with neck problems we ask you to fill out this form so that we can gather vital information regarding you issue. The questions are divided into sections that will help your Physical Therapist to treat the problem. |
| Oswestry Low Back Index (download 152KB .pdf) |
| This form is for patients experiencing back pain. There are 10 sections that cover everything from pain intensity to sleeping, standing, sitting and social life. |
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