Paramount Rehabilitation Services

Patient Forms

Before your first appointment, you will need to complete forms detailing your medical history so we can safely and effectively treat you.

How to fill out forms

At our offices

• Arrive at least 15 minutes early to your appointment to complete

Print out

• Click on the links below to download files to your computer
• Print out the forms
• Fill out the forms using a pen
• Bring the forms to the office

Online

• Demographics
• Medical History

Paramount patient forms

Click to download to your computer

• Demographics
• Medical History
• Privacy Form
• Compliance
• Authorization for Release of Information
• Patient Intake Packet
• Children’s Case History
• Berg Balance Scale
• The Dash
• Oswestry Low Back
• Hip Functional Assessment
• Knee Outcome Survey
• Lower Extremity Scale
• Neck Disability Index