Patient Resources | handsonhands

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Hands on Hands
Rehabilitation Center, Inc

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Forms

We ask you to please print out the following forms and complete them prior to your initial visit if you elect to not complete them via our online platform. Please bring completed forms with you along with your doctor's prescription, identification card, insurance card, and any additional information provided by your doctor. We look forward to working with you in your recovery.

Patient Forms:

Registration Form

Health History and Medications Forms

Financial Contract, Cancellation and No Show Policy

Notice of Privacy Practices

Upper Extremity Functional Index

Medicare Reporting Index Medicare Patients Only

Spanish Forms: Registration Form

Spanish Forms: Financial, Cancellation and No Show Contract

Spanish Forms: Notice of Privacy Practices

Spanish Forms: Health History and Medication Form

Spanish Forms: Upper Extremity Functional Index

Spanish Forms: Medicare Reporting Index Medicare Patients Only

Hands On Hands Rehab Prescriptions

Hands On Hands Brochure

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