Big Spring Physical Therapy & Sports Medicine
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Intake Forms

We value your time and your privacy. Therefore, we have provided our new patient forms for you to download, print, and fill out at home. Please bring them into our clinic during your next visit.
Medical History Questionnaire
File Size: 53 kb
File Type: pdf
Download File

Patient Information Form
File Size: 525 kb
File Type: pdf
Download File

Notice of Privacy Practices Brochure
File Size: 460 kb
File Type: pdf
Download File

Therapy Participation Form
File Size: 655 kb
File Type: pdf
Download File

Visual Pain Scale Form
File Size: 139 kb
File Type: pdf
Download File

Medicare Medication List Form
File Size: 453 kb
File Type: pdf
Download File

Disability Indices

For your convenience, we have provided a variety of injury forms for you to download, print, and fill out at home. Please bring them into our clinic, along with your intake forms, during your next visit.
Ankle & Foot
File Size: 31 kb
File Type: pdf
Download File

Hip
File Size: 105 kb
File Type: pdf
Download File

Knee
File Size: 29 kb
File Type: pdf
Download File

Knee Surgery
File Size: 51 kb
File Type: pdf
Download File

Lower Back
File Size: 21 kb
File Type: pdf
Download File

Neck
File Size: 61 kb
File Type: pdf
Download File

Shoulder, Elbow, Wrist, Hand
File Size: 53 kb
File Type: pdf
Download File

Shoulder
File Size: 49 kb
File Type: pdf
Download File

Vertigo
File Size: 12 kb
File Type: pdf
Download File

Gait & Balance
File Size: 69 kb
File Type: pdf
Download File

Picture

LOCATION

91 S High Street,
Newville, PA 17241
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TELEPHONE

(717)-776-1058

CONNECT

© 2022 Big Spring Physical Therapy & Sports Medicine. All rights reserved.
  • About
  • Services
    • Facilities
    • FAQ'S
  • Forms
  • Industrial Medicine
  • Staff
  • Locations
  • Careers
  • Contact