New Patient Forms

In order to expedite your first appointment at Leader Therapy, new patients are encouraged to complete new patient forms in advance of your first session.  Please print these, fill them out and then bring them with you to your first appointment.

All Patients Need to fill out the Intake packet below:

• >Intake Form

All Patients need to fill out the index corresponding with their injury below:

• >Back Index
• >Neck Index
• >Shoulder, Arms, Wrist, and Hand Index
• >Hip, Knee, Ankle and Foot Index

If your primary insurance is United Health Care please download and fill out the forms below:

• >PSF-750
• >Keele SBST

This is the HIPPA agreement for your convenience:

• >HIPAA Form