Forms

COVID-19:

• COVID-19 Screening

Allied Health Patient: (Physio, Chiro, RMT, etc)

• Intake Form (Page 1-4)
• Electronic Billing Consent
• Credit Card Authorization
• MVA Form
• Dietitian – Intake form
• Dietitian – 3 day food record

DEXA Patient:

• Intake Form (Page 1)

Medical Patient:

• Intake Form (Page 1)
• Referral Form
• Pain Medicine Form

Performance Nutrition:

• Performance Nutrition Intake
• Performance Nutrition Check-In

Return to Sport

• Tampa Kinesiophobia Scale (TSK-11)
• Return to Sport after Injury Scale (RSI)