Active Release Techniques

Kinesio Taping

Patient Forms

Please print and complete the following forms before coming to your initial appointment. If the patient is under the age of 18, please print and complete the Minor Consent Form. If your health insurance is through Medica or United HealthCare, please print and complete the Insurance Notification Form. If you will be attending the ACL Program or a Fitness Class please print and complete the appropriate forms below.

All new patients will need:

• New Patient Intake Form
• New Patient Release of Records
• New Patient HIPPA Form

Some new patients will need:

• Minor Consent Form (Under 18 years of age)
• Insurance Notification Form (Medica or United HealthCare)

Fitness Class participants will need:

• Fitness Class Registration
• Liability Waiver
• PAR-Q

ACL Program participants will need:

• Athlete Registration
• Liability Waiver
• PAR-Q