Patient intake forms
If you are a new patient to Performance Therapy Group, please download and complete the forms below, and bring them to your scheduled appointment.
All forms are in “.pdf” format and will require Adobe Reader to view.
Click here to download the latest version.
If you are a new patient and have only one problem, complete this form. (4 pages total)
If you are a new patient and have more than one problem, complete this form for each additional problem area. (1 page)
If you have low back pain, please complete this form also. (1 page)
If you have neck pain, please complete this form also. (1 page)
Our doctors are committed to the highest standards of clinical excellence.
Dr. Bomben’s sports background gives him a unique understanding of your injuries and the most effective treatmentsRequest an Appointment now