New Patient Pre-Exam Form in Chapman
Nobody remembers the date it started, the name of the medication or what the scan actually said, not while somebody is waiting for the answer. So here is the whole list ahead of time. Everything your therapist will ask at our Chapman clinic, ready when you are.
What your new patient pre-exam covers.
An evaluation is largely detective work. Your therapist tests you, measures you and watches how you move, but the shortcut to the right answer is usually a sentence you say in the first few minutes. These questions are aimed at that sentence.
Look through them before you come in and answer whatever you can. Nothing is submitted on this page, nothing needs printing, and there are no wrong answers. Skip anything that does not apply. When you want a time, use the booking form further down the page.
Why you are coming in
The reason for your visit in plain language, not medical terms. Where it is, when it began, and whether there was a moment you can point to or whether it simply turned up one day. Then whether it has improved, worsened or stayed flat since, and how it differs from that first week.
What we treat →What makes it better, what makes it worse
Sitting, standing, walking, lifting, sleeping, the first hour of the morning, the last hour of a shift. Heat, ice, movement, rest. Tell us what reliably stirs it up and what reliably calms it, and list the things you have quietly given up because of it.
Request an appointment →Your medical picture
Treatment you have already had for this, imaging, injections and any surgery, and what changed after each one. Then the wider picture: your current medications with dosage and frequency, previous surgeries, and other conditions such as diabetes, heart or blood pressure problems, osteoporosis or pregnancy.
Insurance we accept →What you want back
People undersell this one. Not “less pain”, but the real thing: the stairs at your daughter’s house, a full shift without the brace, picking up a grandchild, sleeping through the night, getting back on the mower. Say it plainly, because it becomes the goal everything else is measured against.
Call (785) 922-4016 →What to bring to your first visit
- Your prescription, if a physician has already written you one
- Your driver’s licence or another photo ID
- Your insurance cards, or your Worker’s Comp or auto claim information
- A list of your medications with the dosage and how often you take them
- Copies of any X-ray, MRI or CT reports connected to this problem
- Your personal calendar, so we can schedule the rest of your visits before you leave
Wear clothes you can move in. Kansas direct access means most patients can start physical therapy without a physician referral, so you are free to call and be evaluated. Some insurance plans do still require one for coverage, so we verify your specific plan before your first visit and tell you exactly where you stand, instead of letting you find out later.
Your Chapman clinic
Tues and Thurs, 7:20 am to 5:00 pm
This is preparation, not a requirement. Call (785) 922-4016 and answer these questions on the phone, or arrive a few minutes early and work through them with us at the front desk. Nobody is turned away for showing up with nothing filled in. Use the form below and we will call you back to confirm your time.