PATIENT FORMS

Direct Access Disclosure

Please print and sign the direct access disclosure if you are being evaluated without a referral.

Dry Needling Consent

Please fill out the dry needling consent form if you wish to receive dry needling.

HIPAA

Please print and sign the HIPAA form that acknowledges the availability of the Notice of Privacy Policy.

Notice of Privacy Policy

Please read over the privacy policy.

Patient Intake Form

Past medical history and consent for physical therapy evaluation and treatment. Please fill out and bring it to your first appointment or email it to jacob@ethosphysicaltherapy.com.

PATIENT FORMS

Direct Access Disclosure

Dry Needling Consent

HIPAA

Notice of Privacy Policy

Patient Intake Form

THE CLINIC

CONTACT