New Patient Paperwork
Once your initial appointment HAS BEEN SCHEDULED, please download and complete your New Patient Paperwork prior to arriving at your Initial Evaluation. If you are unsure as to which paperwork to complete please feel free to give us a call, and we will be happy to assist you. Otherwise, please read the explanations below and click on the link that leads to the appropriate documentation.
**NOTE: These documents are to be downloaded, completed and emailed to denise@herhealthpt.com BEFORE your initial appointment. If you have difficulty completing any of these forms, please call 443-283-2018 or email Denise.
Thank You.
Patients with Orthopedic conditions:
If your Initial Evaluation will be for an incident related to any orthopedic issue (back, knee, neck, etc.) please click the link below to download your New Patient Paperwork:
Along with the above paperwork, Insurance also now requires you to complete one of the following questionnaires:
Patients with Vulvovaginal Health conditions:
If your Initial Evaluation will be for an incident related to any Women's Health issue (pelvic pain, incontinence, pain with intercourse, etc.) please click the link below to download your New Patient Paperwork:
Along with the above paperwork, Insurance also now requires you to complete one of the following questionnaires:
Do you have pelvic pain, pain with intercourse, pain with sitting, and/or Symphysis Pubis Disorder? Please complete BOTH of the following questionnaires:
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Do you have organ prolapse and/or urinary or fecal incontinence? Please fill out the following questionnaire:
Penile/Prostate Health Patients:
If your Initial Evaluation will be for an incident related to any Men's Health Issue (i.e. pelvic pain, incontinence, difficulty with urination/defecation, pain with sitting) please click the link below to download your New Patient Paperwork:
Along with the above paperwork, Insurance also now requires you to complete one of the following questionnaires:
Do you have pelvic pain and/or Prostatitis? Please complete BOTH of the following questionnaires:
Male NIH Symptom Index (NIH-CPSI)
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