{"id":709,"date":"2016-01-29T14:20:09","date_gmt":"2016-01-29T19:20:09","guid":{"rendered":"https:\/\/www.bu.edu\/rehab\/?page_id=709"},"modified":"2023-02-24T14:35:21","modified_gmt":"2023-02-24T19:35:21","slug":"clinic-forms","status":"publish","type":"page","link":"https:\/\/www.bu.edu\/rehab\/scheduling-your-appointment\/clinic-forms\/","title":{"rendered":"BUPTC Clinic Forms"},"content":{"rendered":"<h3>Intake Forms<\/h3>\n<p>Please complete our general intake packet and appropriate questionnaire below prior to your first appointment.<\/p>\n<ul>\n<li>General intake:\n<ul>\n<li>For new onset symptoms: <a href=\"https:\/\/www.bu.edu\/rehab\/files\/2023\/02\/BU-Physical-Therapy-Intake-A.pdf\">BU Physical Therapy Intake A<\/a><\/li>\n<li>For symptoms lasting longer than three months: <a href=\"https:\/\/www.bu.edu\/rehab\/files\/2023\/02\/BU-Physical-Therapy-Intake-B.pdf\">BU Physical Therapy Intake B<\/a><\/li>\n<\/ul>\n<\/li>\n<li><a href=\"\/rehab\/files\/2020\/03\/QuckDASH_English_Fillable.pdf\">Shoulder\/Arm Questionnaire<\/a><\/li>\n<li><a href=\"\/rehab\/files\/2020\/03\/PCSS_English_fillable.pdf\">Concussion Questionnaire<\/a><\/li>\n<li><a href=\"\/rehab\/files\/2020\/03\/ODI_English_Fillable.pdf\">Low Back Questionnaire<\/a><\/li>\n<li><a href=\"\/rehab\/files\/2020\/03\/NDI_English_Fillable.pdf\">Neck Questionnaire<\/a><\/li>\n<li><a href=\"\/rehab\/files\/2020\/03\/LEFS_English_fillable.pdf\">Lower Body Questionnaire<\/a><\/li>\n<li><a href=\"\/rehab\/files\/2020\/03\/KOS_English_Fillable.pdf\">Knee Questionnaire<\/a><\/li>\n<li><a href=\"\/rehab\/files\/2020\/03\/GROC_English_fillable.pdf\">Global Rating Questionnaire<\/a><\/li>\n<\/ul>\n<h3>Release Authorization Form<\/h3>\n<p>If you would like a copy of your medical records, please fill out the <a href=\"\/rehab\/files\/2016\/01\/Rehab-General-Authorization-for-Release-for-PHI.pdf\"><strong>Release Authorization Form<\/strong><\/a> and fax to 617-358-3710 or email to <a href=\"mailto:buptc@bu.edu\">buptc@bu.edu<\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Intake Forms Please complete our general intake packet and appropriate questionnaire below prior to your first appointment. General intake: For new onset symptoms: BU Physical Therapy Intake A For symptoms lasting longer than three months: BU Physical Therapy Intake B Shoulder\/Arm Questionnaire Concussion Questionnaire Low Back Questionnaire Neck Questionnaire Lower Body Questionnaire Knee Questionnaire Global [&hellip;]<\/p>\n","protected":false},"author":10942,"featured_media":0,"parent":67,"menu_order":5,"comment_status":"closed","ping_status":"closed","template":"","meta":[],"_links":{"self":[{"href":"https:\/\/www.bu.edu\/rehab\/wp-json\/wp\/v2\/pages\/709"}],"collection":[{"href":"https:\/\/www.bu.edu\/rehab\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.bu.edu\/rehab\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.bu.edu\/rehab\/wp-json\/wp\/v2\/users\/10942"}],"replies":[{"embeddable":true,"href":"https:\/\/www.bu.edu\/rehab\/wp-json\/wp\/v2\/comments?post=709"}],"version-history":[{"count":25,"href":"https:\/\/www.bu.edu\/rehab\/wp-json\/wp\/v2\/pages\/709\/revisions"}],"predecessor-version":[{"id":1513,"href":"https:\/\/www.bu.edu\/rehab\/wp-json\/wp\/v2\/pages\/709\/revisions\/1513"}],"up":[{"embeddable":true,"href":"https:\/\/www.bu.edu\/rehab\/wp-json\/wp\/v2\/pages\/67"}],"wp:attachment":[{"href":"https:\/\/www.bu.edu\/rehab\/wp-json\/wp\/v2\/media?parent=709"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}