Greencastle Physical Therapy
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Intake Forms

We value your time and your privacy. Therefore, we have provided our new patient forms for you to download, print, and fill out at home. Please bring them into our clinic during your next visit.
Medical History Questionnaire
File Size: 62 kb
File Type: pdf
Download File

Patient Information Form
File Size: 525 kb
File Type: pdf
Download File

Notice of Privacy Practices Brochure
File Size: 482 kb
File Type: pdf
Download File

Therapy Participation Form
File Size: 664 kb
File Type: pdf
Download File

Visual Pain Scale Form
File Size: 138 kb
File Type: pdf
Download File

Medicare Medication List Sheet
File Size: 450 kb
File Type: pdf
Download File

Disability Indices

For your convenience, we have provided a variety of injury forms for you to download, print, and fill out at home. Please bring them into our clinic, along with your intake forms, during your next visit.
Hand and Wrist Injury
File Size: 44 kb
File Type: pdf
Download File

Lower Back Injury
File Size: 137 kb
File Type: pdf
Download File

Foot Injury
File Size: 46 kb
File Type: pdf
Download File

Hip Injury
File Size: 93 kb
File Type: pdf
Download File

Ankle and Foot Injury
File Size: 43 kb
File Type: pdf
Download File

Neck Injury
File Size: 135 kb
File Type: pdf
Download File

Knee Injury
File Size: 64 kb
File Type: pdf
Download File

Shoulder Injury
File Size: 49 kb
File Type: pdf
Download File

Upper Extremity Injury
File Size: 44 kb
File Type: pdf
Download File

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Location

145 E Baltimore Street, Suite 2
Greencastle, PA 17225

Telephone

(717) 643 - 1813

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© 2022 Greencastle Physical Therapy & Sports Medicine. All rights reserved.
  • About
  • Services
    • FAQ'S
  • FORMS
  • Industrial Medicine
  • Staff
  • Press
  • Contact