Patient Info / Forms

We are here to help you enjoy your life, pain-free! To make a convenient appointment, simply call us today at 301-652-2161 or click here to request an appointment online. Our practice is dedicated to the conservative management of scoliosis and spine conditions. Our practice is also devoted to helping you identify the cause of your pain and creating a custom treatment program that will allow you to return to normal activities pain-free.

At Graham Therapy and Fitness, we want to maximize your time with us. In order to save time on your first visit, please complete the forms online (preferred method) or please complete all online forms 24-48 hours in advance of your first appointment. You may also print them out and bring in completed to your first visit.

New Patient Forms

Once you have an appointment scheduled, please complete Step 1 and Step 2 below. Step 1 creates your patient record with us, and Step 2 collects your history.

STEP 1: Online Registration

PRIVACY STATEMENT
Please note that no personal information from this form will be stored on our website database. All information is securely directed and saved in our clinic’s Electronic Medical Record (EMR) system where all data is encrypted. The patient information will only be used by the clinic and will not be passed on to any third party.

Click here for Notice Of Privacy Practices

STEP 2: Patient History

Before Your First Visit

  • Make a list of questions that you have to discuss on your first visit.
  • List signs and symptoms that can be of importance to the therapist.
  • Have in writing key past medical history, previous treatments, current medications, and other important information.
  • Please call your insurance to verify your insurance benefits for out-of-network physical therapy, please determine your coverage for this treatment, and also what steps are necessary for you to pursue reimbursement. Please see the “Payment Info” tab for further guidance when speaking with your insurance company.
  • Arrive 15 minutes early for your first appointment.
  • Bring with you a copy of your insurance card and a photo ID.
  • Please complete all intake forms prior to your first visit.

Please bring the following to the first appointment:

  • All physician contact information (e.g. pediatrician, primary, orthopaedic, etc.) including phone and fax numbers.
  • All X-rays. (Be prepared to leave them with therapist for a day or two.)
  • Current day and/or night braces for scoliosis/kyphosis patients.
  • A water bottle.
  • Notebook, pen, and paper to take notes as needed.
  • 3-ring binder or folder to assist in organizing paperwork (optional)
  • Snack or plan for meal at local restaurants near the clinic during break for Scoliosis/Kyphosis Patients.
  • Parents/Family accompanying patient minors may wish to bring reading material or other activity as they will be invited to view exercises periodically, but not necessarily throughout every session.

Clothing to wear to your first and ongoing appointments:

  • All patients are asked to wear loose or form fitting shorts, elastic waist preferred. The shorter the shorts the better, this allows for full visualization of the legs.
  • Females, please wear a bra top (preferable), sports bra with an OPEN BACK (see examples), or bikini top (preferable). Please do NOT wear a racer-back sports bra or any sports bra in which the straps cover the center of the spine in any manner. This is very important. Please search “open back sports bra” in your browser to find a top that works well for you. The spine needs to be visualized optimally. Examples of sports bra styles which will work well for scoliosis/kyphosis physical therapy are provided below:

Below are examples of sports bra back strap styles that do NOT work well for scoliosis/kyphosis specific physical therapy:

  • Footwear should be athletic and comfortable.

Hair

  • Long hair will need to be secured into a bun that sits on top of the head, and bangs should be secured with a barrette.

After training:

  • At the completion of the scoliosis/kyphosis program, a wall ladder, stall bars or wooden bars should be installed and all equipment should be in place.
  • Immediate continuation of the exercises in the home should be initiated the day following the last day of training. It is imperative that the wall ladder or stall bar system is installed in the home, prior to completion of training and ready for immediate use.
  • Follow-up visits will be recommended at the completion of the training session. It is the patient’s responsibility to contact Graham Therapy and Fitness to schedule their appointment.

What to Expect on Your First Visit

  • You will register with our friendly front office staff. They will help you navigate any questions you may have regarding the registration process and treatment program, so you can focus on your recovery.
  • You will meet with your physical therapist for the initial evaluation.
  • During the evaluation, your therapist will ask questions about your medical history, current pain, or injury. Open communication helps us understand your problem.
  • Your movement, strength, coordination, and much more will be evaluated. Our purpose is to help you, so please ensure you communicate with your therapist if anything is hurting or bothering you during the examination.
  • Your therapist will recommend and prepare a course of treatments to ensure the quickest recovery and the best results. Your therapist will discuss the recommendations with you.
  • There will be some treatments performed the first day to get you started on your road to recovery. However, during the next visit you will get into the full swing of your treatment plan.
  • You will schedule your series of visits with the front desk. The amount of therapy needed will be discussed with you, depending on the recommendations of your therapist. We offer many convenient appointment times, however, prime times can become busy, so it is best to book ahead as much as possible.
  • Your therapist will write up their findings and treatment plan.
  • If you have any questions at any time, please don’t hesitate to call. We want to ensure your satisfaction and full recovery.