Alpine Physical Therapy
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      • Samantha Schmidt
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  • Home
  • Approaches
    • Aquatic Therapy
    • CoreAlign®
    • IASTM
    • Functional Dry Needling
    • Pilates-based rehabilitation
    • PRRT™
    • Rehabilitative Ultrasound Imaging
    • Work Injury Management
  • Programs
    • Bone Health
    • Dance Medicine
    • Lymphedema Management
    • Oncology Rehabilitation
    • Pain Science
    • Post-Operative Rehabilitation
    • Spine Rehabilitation
    • Sports Rehabilitation
    • Vestibular & Balance
    • Pelvic Health
  • Patients
    • Patient Stories
    • Locations
    • Resources >
      • Conditions
      • Health Information
      • Pain Education Resources
      • Occupational Health
      • Links
      • Insurance Information
      • Product Resources
    • Online Bill Pay
    • Paperwork
  • About Us
    • Our Therapists >
      • Ana Soulia
      • Angela Listug-Vap
      • Antara Quiñones
      • Brent Dodge
      • Brace Hayden
      • Dennis McCrea
      • Francisco Quiñones
      • Gary Gales
      • Jeff Soulia
      • Jessica Kehoe
      • Jocee Long
      • Josie Stokken
      • Kimberly Mize
      • Kristi Moore
      • Leah Versteegen
      • Lisa Hamilton
      • Mary Mischke
      • Matt Schweitzer
      • Megan Fisher
      • Samantha Schmidt
    • Certifications
    • Community Outreach
    • Why Alpine?
    • Patient Reviews
    • Events
  • Blog
  • Contact
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YOUR CART

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Save time! You can print and fill out all of the first visit Forms, and bring them with you to your first appointment.

First Visit Forms - Please print and fill out these forms to bring with you on your first visit.

Guideline and Medical Records Release
Medical Information
Patient Medication List
Patient information

When you call our office to schedule your first visit, we may ask you to fill out one (or more) of the following forms. We’ll explain to you at that time which one (or two) we need you to print, fill out, and bring with you on your first visit.

Balance/Dizziness Intake Addendum
(Only Necessary for Vestibular/Dizziness/Balance Patients)
Dizziness
Foot
Headache
Knee
Leg
Low Back
Neck
Shoulder/Arm
Wellness Program Intake

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Get to know us better. Our social media platforms are a great way to learn about our staff, upcoming events, newest technology, patient stories, and more.

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