PATIENT CENTER

New Patients:  To help us serve you better, we have TWO​ forms (instructions below) that we would like you to complete before you come in for your first visit. 

If you can't complete the forms online, we ask that you please arrive to your first appointment 30 minutes ahead of your scheduled time. Otherwise, please arrive 5-10 minutes prior to your scheduled appointment time.

Please remember your photo id and insurance cards. (And if applicable, your current medication list, physician referral, and any copay or deductible payment due).  ​ 

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Form #1: Click on the button for the pre-exam form under the clinic location you will be seen.  The link will take you to a survey form. Please fill out to the best of your ability and hit SUBMIT. Once the form is submitted, it will direct you to a new page with Form #2, or you can return to this page and scroll down. If you are unsure which location you are at, please call 785-263-3646. 

​Abilene Location

Pre-Exam Form #1

Chapman Location

Pre-Exam 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.  

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
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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. 

​Pelvic Floor:  For pelvic floor dysfunction-incontinence, constipation, pelvic pain, or pre/post natal.