In Motion Patient Forms

Save time on your first visit and fill out our forms in advance. Everyone should fill out the patient registration, medical history and personal representative/medical record forms.

Physical Therapy

Patient Forms

• All patients attending Southside clinics (Carollton, Chesapeake, Norfolk, Portsmouth, Suffolk and Virginia Beach) access forms here
• All patients attending Peninsula clinics, access forms here

What’s included:

• • Medical History Form
    A questionnaire that helps us to understand the big picture of your health.
  • Patient Responsibilities
    This form lets you know what we expect from our patients during appointments and what you can expect from us.
    

**You can call the physical therapy clinic directly to schedule your initial evaluation with Direct Access, now available at all location. Get more information about Direct Access.