Patient Forms

Genuine Rehab and Wellness always seeks to provide you with the best quality of care…This includes maximizing your time with us in the clinic to be hands on in addressing your problems, not filling out papers! However, these papers are important.

If you have access to a printer, please complete the following forms PRIOR to your visit, print and bring with you to provide for the therapist to review.

Please Note: No personal information from this form will be stored on our website database. All information is securely directed and saved in our clinic’s Electronic Medical Record (EMR) system where all data is encrypted. The patient information will only be used by the clinic and will not be passed on to any third party.