2315 W Arbors Dr STE 120, Charlotte, NC 28262 (704) 971-9194

Profit Health& Wellness
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    • About
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Profit Health& Wellness
  • About
  • Staff
  • Services
  • Forms
  • Contact
  • FAQ

New Patient Forms

New Patient Intake Form (doc)

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Patient Personal Information (pdf)

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Acknowledgement (pdf)

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Dry Needling Consent Form (pdf)

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Minor Consent Form (docx)

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Extremity Questionnaire Forms

General Lower Extremity Scale (pdf)Download
General Upper Extremity Scale (pdf)Download
Low Back Questionnaire (pdf)Download
Neck Disability Index (pdf)Download
Shoulder Pain and Disability Index (pdf)Download
Elbow and Wrist Questionnaire (pdf)Download

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