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915-595-4500
Please click on the links below to download the appropriate forms. These are the forms you will need to fill out prior to being seen. If you print them and complete them prior to your appointment, this will make the check-in process quicker. Physical Rehabilitation(general therapy)-English New Patient Forms(print and fill out by hand) New Patient Forms(fill out online and print) Physical Rehabilitation(general therapy)-Spanish New Patient Forms Functional Capacity Evaluation-FCE Consent Form(all patients scheduled for a FCE) Physical Screening Questionnaire(all patients scheduled for a FCE) Dallas Pain(all patients scheduled for a FCE) Neck Disability (neck injuries only) Oswestry(back injuries only) View our sample functional capacity evaluation Rehabilities  Privacy Practices (HIPAA) This is our policy of how we protect your private information and medical records. This is a Federal Law that requires all health care practices to conform with. Medical Records Release This is used when you want us to send your records to yourself or another professional (i.e. attorney, physician, etc.) Rehabilities Prescription Please download and print this to take to your physician if you need a prescription for therapy.  A prescription signed by your physician is required to receive therapy Please call our Office at (915) 595-4500 if you have any questions. You will need Acrobat Reader for viewing the PDF files. To get a free copy of Acrobat Reader, click here.
PATIENT INFO > DOWNLOAD FORMS
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East Side Office 7230 Gateway Blvd. E. Ste. F El Paso, Texas 79915 West Side Office 7815 Helen of Troy Ste. B El Paso, Texas 79912 Phone:  915.595.4500 Fax:  915-595.4502 Email:  contact@rehabilities.com