Patient Info / Forms

Welcome to ProMotion Rehab and Sports Medicine

We are here to help you enjoy your life, pain-free! To make a convenient appointment, simply call us today. Our practice is dedicated to helping our patients identify the cause of their pain and creating a custom treatment program that will allow them to return to normal activities pain-free.

Patient Forms

At ProMotion Rehab and Sports Medicine, we want to maximize your time with us. Prior to your first visit, please follow the New Patent Forms link below. Download, print and fill out the New Patient Forms below, and bring them with you to your first visit along with your insurance information and photo ID.

• 1

  New Patient Forms

  Download & Print
• 2

  Telehealth Forms

  Download & Print

Complete these forms based on what area you need treated:

• Lower Back
  • Please fill out the Oswestry Back Index (OBI) Form
• Neck
  • Please fill out the Neck Disability Index (NDI) Form
• Hip, Knee, Foot or Ankle
  • Please fill out the Lower Extremity Functional Scale Form
• Shoulder, Elbow, Wrist or Hand
  • Please fill out the QuickDASH Form
• Balance
  • Please fill out the Falls-Efficacy-Scale Form
• Ages 65 & Up
  • Please fill out the Geriatric Depression Scale Form
  • Please fill out the Elder Abuse Suspicion Index Form
  • Please fill out the Falls-Efficacy-Scale Form

Self-Pay

• $120 for a physical therapy 40 minute session