(360)279-8323
info@rueandprimavera.com
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Services
Physical Therapy
Hand Therapy
Occupational Therapy
Women’s Health Care
Pediatric Occupational Therapy
Aquatic Therapy
Vestibular Rehabilitation
Lymphedema Therapy
Deep Tissue Laser Therapy
Splints
Wellness Program
Deep Tissue Laser Therapy
Langley Hand Clinic
Virtual Therapy
Virtual Workshops
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Patient Forms
We would like to make your appointment as easy as possible. Please take your time filling out these forms. If you have questions in regards to which form to fill out please call us!
New Patient Intake Packets
Patient Intake Packet- Occupational/Physical Therapy
Patient Intake Packet- Pelvic Floor Physical Therapy (Females Only)
Patient Intake Packet- Pelvic Floor Physical Therapy (Males Only)
Patient Intake Packet- Pediatric Occupational Therapy
Forms
COVID-19 Informed Consent & Wellness Screening
Authorization to Release Medical Records
Patient Request for Medical Records
No Show/Cancellation Policy Form
Informed Consent Laser Therapy
Laser Medical History
Notice of Privacy Practices
Physical Therapy Outcome Measure
Lower Extremity Function
Neck Disability Index
Modified Oswestry Disability Scale
Shoulder Pain & Disability Index
Dizziness Handicap Inventory
Occupational/Hand Therapy Outcome Measure
Quickdash
Pelvic Floor Outcome Measures
Pelvic Floor Distress
Pelvic Floor Impact Questionnaire- PFIQ
Initial Vulvar Pain Functional Questionnaire (V-Q)
Queensland Female Pelvic Floor Questionnaire
NIH- Chronic Prostatitis Symptom Index (Males Only)
O'Leary Sant
Lymphedema Outcome Measure
Lymphedema Life Impact Scale- LLIS
Questions? 360-279-8323
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