Skip to main content

New Patient Forms

Save time during your first appointment by completing the following applicable forms prior to your visit with Dr. Thayer. Please bring the completed form(s) with you to your appointment.

General New Patient Forms:

New Patient Questionnaire

Auto Accident Forms

Personal Injury Questionnaire
Accident History Questionnaire

ASH Forms

Initial Health Status Form

Optum Forms

Patient Summary Form
Keele STarT Back Form

Neck and Low Back Index Forms

Neck Index Form
Low Back Index Form