OrthoSport HQ
  • Home
  • Services
    • Physical Therapy
    • Performance
  • Meet The Team
  • Resources
    • Insurance Card Info
    • Cancellation Policy
    • OrthoSport Videos >
      • Head/Neck
      • Upper Back
      • Shoulder
      • Hips/Low Back
      • Knee
      • Foot/Ankle
    • Community Partners >
      • WRRFC Members
      • Living Lean Members
      • CF2 Members
      • Bike Ohio Members >
        • Cycling page
      • Sanders Chiropractic
  • Book Appointment
  • Contact Us
    • Workshops >
      • Event Sign up
  • HOLIDAY PARTY
  • Home
  • Services
    • Physical Therapy
    • Performance
  • Meet The Team
  • Resources
    • Insurance Card Info
    • Cancellation Policy
    • OrthoSport Videos >
      • Head/Neck
      • Upper Back
      • Shoulder
      • Hips/Low Back
      • Knee
      • Foot/Ankle
    • Community Partners >
      • WRRFC Members
      • Living Lean Members
      • CF2 Members
      • Bike Ohio Members >
        • Cycling page
      • Sanders Chiropractic
  • Book Appointment
  • Contact Us
    • Workshops >
      • Event Sign up
  • HOLIDAY PARTY
​Please take a moment to fill out our online intake form before your visit. All information is kept completely confidential.

    OSHQ EVENT SIGN UP FORM:

Submit

Event Consent Form:

I authorize the clinic and its associated health professionals to collect my personal and medical information as documented above. 

In addition, I authorize the clinic and its associated health professionals to communicate with my family doctor and/or referring doctor  as deemed necessary for my beneficial treatment. I also understand that my personal and medical information is confidential and will only be disclosed to third parties with my permission.

​I affirm that the therapist has my consent to treat by whatever reasonable means deemed necessary and provide an exercise plan utilizing their expertise and education
Site powered by Weebly. Managed by JustHost