Client Forms

Download, Print , Fill Out and Bring!

 

Recovery StoriesBook Appointment
In order to get you checked in quickly when you arrive, our forms are available here!

Please download and print the appropriate form below. Fill it out and bring it with you to your first visit. If you have any questions, please contact us at 503-885-8677.

pdfdownloadlogoHealth History Questionnaire
This form is just for your first visit.

pdfdownloadlogoWomen’s Health Questionnaire
This form is for women who need help with women’s issues

pdfdownloadlogoMen’s Health Questionnaire
This form is for men who need help with men’s issues

pdfdownloadlogo   Pelvic Health Consent Form
This form is for both men and women

What Software Do I Use to Open the Forms?
Once downloaded, these forms should open easily on your computer already. If not, please download and install the free Acrobat Reader onto your computer.

pdfdownloadlogoLower Extremity Functional Scale (LEFS)
This form is people dealing with leg pain or problems

pdfdownloadlogoOswestry Neck Pain
This form is for people with neck pain

pdfdownloadlogoOswestry Low Back Pain
This form is people with pain in their lower back

pdfdownloadlogoQuick – Disability of the Arm, Shoulder, and Hand (Q-DASH)
This form is for people with arm, shoulder, and hand problems

pdfdownloadlogoPelvic Floor Distress Inventory (20)
If you are experiencing urinary incontinence, rectal incontinence or pelvic organ prolapse

pdfdownloadlogoVulvar Pain Questionnaire
If you are experiencing genital pain

What Software Do I Use to Open the Forms?
Once downloaded, these forms should open easily on your computer already. If not, please download and install the free Acrobat Reader onto your computer.

 

Don't Be Shy. Our Hands-On Therapists Specialize in Healing Touch.

Rather than hook you to a machine and leave you for the duration of your appointment, you’ll experience a significantly different, and caring approach here. Our clients rave about it.

iN Touch Physical Therapy /Ellen Nona Hoyven PT, President

 

COVID-19 UPDATE

 

iN Touch Physical Therapy remains up to date with the safety and cleaning protocols necessary during the COVID-19 pandemic to keep our clients, team, and community safe.

As recommended by the CDC, medical health authorities, as well as local public health authorities, we are performing preventative measures, including:

  • Screening for wellness
    (ie: recent illness, respiratory/breathing difficulty, cough, fever, sore throat prior to scheduled appointment)
  • Professional Electrostatic Disinfection Cleaning of entire clinic
  • Continuous sanitation of all common areas, electronics, and equipment
  • Treatment is in private sanitized 1:1 treatment spaces
  • Frequent hand washing by team ( no rings )
  • Hand washing station for clients upon arrival and when leaving
  • Masks for ALL who enter the clinic as we keep "Social Distancing" protocol
  • Requesting clients to wear masks when out of home
  • Glove use as indicated

iN Touch PT is walking through this unpredictable season with you. The state of the world has forced the general population to become more sedentary, which can lead to an increase in pain/symptoms, which can also lead to increased risk of sickness.

Staying ACTIVE with iN Touch PT through exercise and activities you enjoy, we can improve your health, mind, and lifestyle by prioritizing your overall wellness. We continue to press onward toward “normalcy” again, promoting your BEST HEALTH and outcome with PT!

Wishing you and your families safety and hope !