(937) 252-2000

Patient Forms

For first time visitors.

We may ask that you fill out additional forms for your next visit. Please download the paperwork here, fill them out, and bring with you to your next appointment.

An infosheet about preventing opioid addiction and abuse.

Your privacy rights under HIPPA.

Our missed appointment policy.

Patient medical history, medication history, medical records (PHI) release form.

Because these drugs have the potential for abuse, we enforce the following measures to ensure accountability.

Effective as of April 2018.

Physician supervised PT program for neck.

Physician supervised PT program for lumbar.