ADDRESS

1552 Broadway St.
Longview, WA 98632

PHONE

360-577-8442

New Patient Forms

Please feel free to download and complete the following forms prior to your appointment:

(If you need any assistance in completing these forms, please do not hesitate to contact us!)

 

New Patient Information. The information we need to add you as a new patient.

Download

Past Health History. This information is important in helping the doctor understand your condition.

Download

 

Outcome Assessments

These questionnaires help the doctor to understand how your problems affect your life.

 

Neck Disability Index. Each question has six possible answers. Pick the answer that fits you the best.

Download

Headache Disability Index. Each question has 3 possible answers: Yes, Sometimes and No.  Yes = all of the time, No = none of the time and Sometimes = anything between.

Download

Revised Oswestry Low Back Pain Questionnaire.  Each question has six possible answers. Pick the answer that fits you the best.

Download