Patient Forms - KOH Physical Therapy Lab

Please fill out the Patient Intake Form

If you would like to request an appointment or if you are schedule to come in.

If you do not feel comfortable filling out the digital form below, please feel free to print the paper version and bring with you to your evaluation appointment along with any other important documents.

KOHPT NewPatient Forms +EVAL Q
KOHPT Functional Assessment form – BACK
KOHPT Functional Assessment form – NECK
KOHPT Functional Assessment form – Upper Extremity UEFI
KOHPT Functional Assessment form – Lower Extremity LEFS

Please feel free to text us or call us to schedule an appointment.

Please fill out the Patient Intake Form If you would like to request an appointment or if you are schedule to come in.

Please fill out the Patient Intake Form

If you would like to request an appointment or if you are schedule to come in.