|
|
Patient Resources
New Patient Form:
Below is the New Patient Registration Form. You may click on the icon or link to view the form in PDF. You will need Adobe Acrobat Reader to read and print files in Portable Document Format (PDF). Click here to download a free copy.
Please fill out the entire form and bring to your first appointment.
Registration Form
In addition, please bring the following information on your first visit:
- Any x-ray, MRI or CT scan films or reports that you already have in your possession. We will call your facilities for a report if it is inconvenient for you to obtain them.
- A list of all medications you are taking, including non-prescription medications or vitamins
- All patients under the age of 18 must be accompanied by a parent or guardian.
- No preparation is needed if you are scheduled for an EMG/NCV test. However, we ask that you do not apply lotion to your skin in the area to be tested.
- Your insurance cards along with your co-pay. Payment at the time of service is required for all co-pays. Please contact our office regarding our fees and payment policies if you are without insurance coverage.
Links:
American Physical Therapy Association
American Association of Physical Medicine and Rehabilitation
Web M.D.
Spine Universe
The Orthopedic Surgery Center at Beeghly Medical Park
The McKenzie Institute, USA
The Neuropathy Association
Racing4Research
|
822 E. Western Reserve Road
Poland, Ohio 44514
330.758.8223
|
225 East State Route 14, Suite 206
Columbiana, Ohio 44408
330.482.6063
|
654 Youngstown-Warren Road
Niles, Ohio 44446
330.758.8223
|
|