• About Us
    • Meet the Team
    • FAQ >
      • Insurance
      • Intake Forms
    • For Physicians
  • Golf Performance
  • About PT
  • What We Treat
    • Surgical Prep and Rehab
    • Spine Care
    • Dizziness and Vertigo
    • Neurological Conditions
    • Orthopedic and Sports Injuries
    • Balance or Falls
    • Arthritis
  • How We Treat
    • Manual Therapy
    • Corrective Exercises
    • Movement Analysis
    • Dry Needling
    • Cupping/Soft Tissue
  • Contact
  • Blog
Deabay Physical Therapy & Golf Performance
  • About Us
    • Meet the Team
    • FAQ >
      • Insurance
      • Intake Forms
    • For Physicians
  • Golf Performance
  • About PT
  • What We Treat
    • Surgical Prep and Rehab
    • Spine Care
    • Dizziness and Vertigo
    • Neurological Conditions
    • Orthopedic and Sports Injuries
    • Balance or Falls
    • Arthritis
  • How We Treat
    • Manual Therapy
    • Corrective Exercises
    • Movement Analysis
    • Dry Needling
    • Cupping/Soft Tissue
  • Contact
  • Blog

Intake Forms

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New patients may either print and complete the forms below in advance of our first visit, or we can complete them together.

New Patient Form (Word Document)

New Patient Form (PDF)

Consent to Treatment

Authorization to Release Healthcare Information

Notice of Privacy Practices

Payment Agreement
Contact  |  FAQ  |  For Physicians  |  Insurance  |  ​Intake Forms   ​        
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[email protected]
Phone: 207-249-6621
​Fax: 207-512-1254

336 Mount Hope Suite 9, Bangor, Maine
  • About Us
    • Meet the Team
    • FAQ >
      • Insurance
      • Intake Forms
    • For Physicians
  • Golf Performance
  • About PT
  • What We Treat
    • Surgical Prep and Rehab
    • Spine Care
    • Dizziness and Vertigo
    • Neurological Conditions
    • Orthopedic and Sports Injuries
    • Balance or Falls
    • Arthritis
  • How We Treat
    • Manual Therapy
    • Corrective Exercises
    • Movement Analysis
    • Dry Needling
    • Cupping/Soft Tissue
  • Contact
  • Blog