New Patient Information
May 26 2009
Welcome to Fast Track Physical Therapy & Sports Medicine! We realize how valuable your time is, so for your convenience, we have put together some information that will help speed along your first visit with us. Below, you will find a collection of documents that will need to be filled out before your initial evaluation. If you would prefer, we are happy to print these off for you and have you fill them out while you are right here in our office.
Everyone needs to fill our our
Medical Intake Form as well as our
Pain Questionnaire. In addition to this we ask that you please choose the corresponding Questionnaire for your specific injury. We want to cater to your needs, and the more information we can have about your particular injury/pathology, the better. For example, if you are having back or neck pain, please fill out the Neck/Back Questionnaire, along with the Medical Intake Form and the Pain Questionnaire. If you are experiencing knee or ankle pain, we would ask that you fill out the Lower Extremity Questionnaire instead of the Neck/Back Questionnaire.
If you are a customer of United Health Care (UHC), we also need you to fill out the
United Health Care Questionnaire.
We look forward to seeing you soon, and hope that these documents save you some valuable time. If you have any questions about which form(s) you should fill out, please feel free to contact us by phone at (801) 649-4690, or by email at
office@fasttrackphysicaltherapy.com.
Fast Track Medical Intake Form
May 26 2009
Fast Track Pain Questionnaire
May 26 2009
Neck/Back Questionnaire
May 26 2009
Arm/Shoulder/Hand Questionnaire
May 26 2009
Lower Extremity Questionnaire
May 26 2009
United Health Care Questionnaire
May 26 2009