(785) 263-3646 · 103 NW 15th St, Abilene, KS 67410
Abilene Physical Therapy and Sports Rehab

Pre-Exam Forms

Answering questions in a waiting room is time you could have spent being treated. Fill in the form that matches your problem before you come in, and your first session starts on treatment instead of on a clipboard. It is completely optional. It is also the easiest thing you can do to make your evaluation sharper.

01Find Your Form

By problem first, then by clinic.

Each pre-exam form asks about one area of the body: where it hurts, when it started, what makes it worse, and what you have already tried. Your therapist reads it before you arrive, so the evaluation begins from what you have already told us instead of from scratch. Pick the form that matches your main complaint. If you are not sure which one that is, use the new patient form and we will sort the rest out together.

Every form is listed twice, once for each clinic. Choose the location where your appointment is booked. Open the one you need, answer what you can, and bring it with you.

New Patient

Your first visit with us, whatever it is that brought you in.

Abilene → Chapman →

Back Pain

Low back, mid back, and the pain that travels down into the leg.

Abilene → Chapman →

Neck

Stiffness, headaches that start at the base of the skull, pain into the arm.

Abilene → Chapman →

Upper Extremity

Shoulder, elbow, wrist and hand, including post-surgical recovery.

Abilene → Chapman →

Lower Extremity

Hip, knee, ankle and foot, from a fresh sprain to a joint replacement.

Abilene → Chapman →

Balance and Falls

Unsteadiness, near misses, or a fall that has already happened.

Abilene → Chapman →

Dizziness and Vertigo

Spinning, light headedness, or the room moving when you roll over in bed.

Abilene → Chapman →

Booked for a yearly movement check instead? Start with the Annual PT Exam pre-visit page, which walks through what we will ask and what to bring. Everything else you need before a first appointment lives in the patient center.

Good to Know

Would rather not write anything down? Skip it. We can take your history by phone before your visit or out loud when you arrive, and your evaluation goes ahead either way.

Request an Appointment

Ready when you are.

HoursMon - Fri: 8:00 am - 5:00 pm
Walk-insCall ahead
Book your evaluation. Two Kansas clinics. One on one care.
Step 1 of 5
First things first. What's your name?
We'll need a name to book you in.
Best number to reach you?
A phone number lets us confirm same-day.
And your email?
We'll send your confirmation here.
What questions do you have about your pain or injury?
A few words is all we need.
Look right? Send it.
✓
Request received.

We'll call within business hours to lock in your time.

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