Physical Therapy, Physical Therapists MA Rhode Island - Specht Physical Therapy

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Registration Forms

You can download and print the forms below to fill them out prior to arriving for your first appointment.

1. Patient Registration (PDF)

2. Medical History (PDF)

3. Print the ONE form that describes where you are having most of your problems:

	Back and Hip Condition Questionnaire (PDF)
	Neck Condition Questionnaire (PDF)
	Shoulder, Elbow and Hand Questionnaire (PDF)
	Knee, Foot and Ankle Questionnaire (PDF)

Optional: Notice of Privacy Practices (PDF) can be viewed (does not need to be printed) prior to signing the HIPAA Acknowledgement on the Registration Form.

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Specht Physical Therapy - Orthopedic & Sports Physical Therapy Center - Providing the best Orthopedic & Sports Physical Therapy in the Providence, RI and Fall River, MA areas. Authorized Golf Fitness Provider by the Titleist Performance Institute.