Downloads

Below are the forms you may bring with you prior to your first visit. Please print and fill them out along with the proper documentation. Please bring your drivers license, or some other form of identification, your insurance card, and a form of payment. Most insurance accepted. We accept cash, local checks, and all major credit cards.

 

adobe_acrobat_pdf_iconPatient Registration Paperwork (Fill out highlighted areas only.)

You can print the paperwork and bring it with you to your appointment OR you can fill it out online and email it to us.
Kirby location: afehnel@rehabetc.com
Bartlett location: sembrey@rehabetc.com
Collierville location: lwilson@rehabetc.com
Oakland location: kgcurle@rehabetc.com
Nashville location: jhebert@rehabetc.com

adobe_acrobat_pdf_iconRunner’s Questionnaire (Collierville Location Only)