If you would like to be referred to our clinic for treatment, please feel free to print the attached form and present it to your physician. He will fill out this form and send it to our office. We will then schedule a timely visit with you.
Please feel free to print the attached intake form, fill it out, and bring it to your first visit.
Pelvic Floor Forms
If you are being seen for pelvic floor physical therapy, please download the applicable form(s) below and bring them to your initial visit. Therapy related to bladder disorders require two days of a bladder diary. If you are being seen for therapy related to dysfunctional bowel movements, please record up to 7 days prior to your initial evaluation (as you are able). If you have any questions, please feel free to call 231-744-0077.