Downloadable forms
Here are some forms that you will need to fill out prior to seeing Dr Waerlop or Dr Asthalter.
The first is an intake form, identifying your self, insurance information (if applicable), a description of your problem, and information about your past history.
The second is a pain diagram. This tells the doctors where your pain or problem is (if applicable), what it feels like, and grades it on a scale.
The third is a HIPPA compliance form. If there is any information from your file you would not like the doctors to share with anyone or you insurance company, you must indicate so on this form.
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Pain diagram.pdf
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financial_policy.pdf
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