Spring Session begins Monday, January 27, 2025 and ends May 2, 2025 Please print and fill out initial evaluation paperwork and bring it with you on your first appointment. Medical History Form NAME First Last Phone Email Date of Birth Preferred Appointment Time What is your preferred appointment day/time (select all that apply)? Monday 2:30-4:30 p.m. Wednesday 2:30-4:30 p.m. Friday 2:00-4:00 p.m. Reason for your visit Please indicate primary complaint/area(s) for treatment. (brief description of pain/injury, recent surgery etc.) If you have seen any other medical providers/had imaging done- please list This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.