Element
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Meet the Staff The Clinic Corporate Wellness
How We Treat Chiropractic Adjustments Selective Functional Movement Assessment Active Release Technique Kinesiology Taping Cupping Pilates-Based Rehabilitation
How We Treat Selective Functional Movement Assessment Instrument Assisted Tissue Mobilization Myofascial Release Technique Craniosacral Therapy Visceral Manipulation Cupping
Forms Chiropractic Insurance Physical Therapy Insurance
About Meet the Staff The Clinic Corporate Wellness Chiropractic How We Treat Chiropractic Adjustments Selective Functional Movement Assessment Active Release Technique Kinesiology Taping Cupping Pilates-Based Rehabilitation Physical Therapy How We Treat Selective Functional Movement Assessment Instrument Assisted Tissue Mobilization Myofascial Release Technique Craniosacral Therapy Visceral Manipulation Cupping
Element
Wellness & Sports Rehabilitation
Blog Patients Forms Chiropractic Insurance Physical Therapy Insurance Testimonials

Patient Forms

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Below you will find information and documentation packets for new chiropractic and physical therapy patients.

Please select the packet pertinent to you (chiropractic or physical therapy), fill out and bring the completed forms to your first appointment.

 

Patient Forms

New Patient Chiropractic Paperwork

New Patient Physical Therapy Paperwork

Existing Patient Paperwork (Chiropractic & PT)

Auto Injury Chiropractic Paperwork

Auto Injury Physical Therapy Paperwork

Work Injury Chiropractic Paperwork

Work Injury Physical Therapy Paperwork

Pelvic Floor New Patient Paperwork

Pelvic Floor Existing Patient Paperwork - Female

Pelvic Floor Existing Patient Paperwork - Male

Records Release Form

How To Check Your Insurance Benefit (Out-of-Network)

Consent To Treat Minor

Copy of HIPAA Notice of Privacy Practices

Connect with us!

Chiropractic and Physical Therapy Care at Two Convenient Locations

Hours

Element Wellness and Sports Rehabilitation

5757 S Macadam Avenue, Suite 150 Portland, OR 97239

 PHONE

(503) 212-6158

FAX

(503) 445-7997

HOURS

7am - 6pm Monday - Friday


 


Element Wellness and Sports Rehabilitation - North

1901 N Killingsworth St, Portland, OR 9721

 

 PHONE

(503) 212-6158

HOURS

7am - 5pm Monday - Friday