Physical Therapy, Physical Medicine &
Rehabilitation performed by Certified Medical
Doctors & Therapists

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



Poland
822 E. Western Reserve Road
Poland, Ohio 44514
330.758.8223

Columbiana
225 East State Route 14, Suite 206
Columbiana, Ohio 44408
330.482.6063

Niles
654 Youngstown-Warren Road
Niles, Ohio 44446
330.758.8223