Patient Intake Form

Past medical history and consent for physical therapy evaluation and treatment. Please fill out and bring it to your first appointment or email it to jacob@ethosphysicaltherapy.com.

Notice of Privacy Policy

Please read over the privacy policy.

HIPPA

Please print and sign the HIPPA form that acknowledges the availability of the Notice of Privacy Policy.

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Dry Needling Consent

Please fill out the dry needling consent form if you wish to receive dry needling.