Patient Information

Depending on your reason for coming into Washington Physical Therapy, we have specific forms that need to be filled out prior to your appointment. Please select the form that best matches your reason for coming in, print and fill the form in it’s entirety. Bring this completed form when you come in and give to the front desk. For further questions, please contact the front desk at 509.547.3725.

Patient Assessment Forms

Pregnancy Mobility Index

Urogenital Distress Inventory

ENGLISH  |  ESPAÑOL

Continence Grading Scale

ENGLISH  |  ESPAÑOL

Pain Disability Index

ENGLISH  |  ESPAÑOL

Upper Extremity Index

ENGLISH  |  ESPAÑOL

Lower Extremity Scale

ENGLISH  |  ESPAÑOL

Neck Pain Questionnaire

ENGLISH  |  ESPAÑOL

Shoulder Pain Index

ENGLISH  |  ESPAÑOL

Lower Back Pain Questionnaire

ENGLISH  |  ESPAÑOL

New Patient? Save time!

For quick and easy registration, please print and fill out a Patient Registraton Form prior to your appointment.
Registration Form