Forms & Feedback

We look forward to seeing you on your first visit. In order to save time, we encourage you to print and fill out the following 4 forms to bring to your appointment.

  1. Health History Form
  2. HIPPAA Privacy Act form
  3. Treatment Consent & Policies
  4. Patient Demographics


Out of Network Worksheet



Also, please print and fill out the appropriate specialty forms below.

  1. Neck index
  2. Back index
  3. Hip/leg/foot index
  4. Shoulder/Arm/hand index
  5. Telehealth consent form


we value your feedback




Or send us feedback directly by filling out the form below:

    I give permission for Manual Therapy Associates to use this information as a direct quote in any and all forms. I understand that my name, contact information, or any other identifying information will NOT be published in order to protect my privacy.

Click to schedule an appointment today!