Thank you for submitting Form #1.
Form #2: This form is more specific to the location of your injury/pain/difficulty and how it affects your function. Please click on the link/description (under the correct clinic location) that most closely matches the location/identity of your injury/pain/difficulty.
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Abilene Location
Back Pain Pre-Exam Form: For low/mid/upper back pain Neck Pre-Exam Form: Any kind of neck pain/injury Upper Extremity Pre-Exam Form: For Shoulder, Elbow, Wrist, Hand, or anywhere on the Upper/Lower Arm. Lower Extremity Pre-Exam Form: For Hip, Knee, Ankle, Foot, Upper/Lower Leg Dizziness/Vertigo: Any difficulties with dizziness or vertigo Balance/Falls: For any difficulties with balance, weakness, or falling risk. Pelvic Floor: For pelvic floor dysfunction-incontinence, constipation, pelvic pain, or pre/post natal. |
Chapman Location
Back Pain Pre-Exam Form: For low/mid/upper back pain Neck Pre-Exam Form: Any kind of neck pain/injury Upper Extremity Pre-Exam Form: For Shoulder, Elbow, Wrist, Hand, or anywhere on the Upper/Lower Arm. Lower Extremity Pre-Exam Form: For Hip, Knee, Ankle, Foot, Upper/Lower Leg Balance/Falls: For any difficulties with balance, weakness, or falling risk. |