Healthy U Physical Therapy, Wellness, Pilates & Aquatic Center
Seeing your Doctor ?
You can print this referral form and take it with you to your Dr's appointment.
Healthy U Referral form.pdf
Adobe Acrobat document [298.9 KB]
Adobe Acrobat document [298.9 KB]
Physical_Therapy_Intake_Form.pdf
Adobe Acrobat document [112.0 KB]
Adobe Acrobat document [112.0 KB]
Low Back Pain Questionaire.pdf
Adobe Acrobat document [474.6 KB]
Adobe Acrobat document [474.6 KB]
Neck Pain Questionaire.pdf
Adobe Acrobat document [313.9 KB]
Adobe Acrobat document [313.9 KB]
Lower Extremity Functional Scale.pdf
Adobe Acrobat document [372.3 KB]
Adobe Acrobat document [372.3 KB]
upper Extremity Questionaire.pdf
Adobe Acrobat document [375.1 KB]
Adobe Acrobat document [375.1 KB]
Pilates Medical Release Forms.doc
Microsoft Word document [218.5 KB]
Microsoft Word document [218.5 KB]
Pilates Liability Release Form.doc
Microsoft Word document [501.5 KB]
Microsoft Word document [501.5 KB]
Questions?
Want to know what your insurance covers?
Free benefit check
Pilates and
Physical Therapy
530-345-1993
Fax: 888-511-3977
Pilates specific questions 530-966-4882 (Kathy)
office.healthyu@gmail.com
Healthy U Referral form.pdf
Adobe Acrobat document [298.9 KB]
Adobe Acrobat document [298.9 KB]
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