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Reimer Wellness Center Wellness Center offers our patient form(s) online so they can be completed it in the convenience of your own home or office.

  • If you do not already have AdobeReader® installed on your computer, Click Here to download.
  • Download the necessary form(s), print it out and fill in the required information.
  • Fax us your printed and completed required form(s) or bring it with you to your appointment.

New Patient Health History Form - Required

This lets us know the history and current state of your health. What questions, concerns, goals, regarding wellness can we help you with? Let us know!

Download & Print Form


Children's Health Record- Required for any patient 18 years or younger

Download & Print Form


Initial Consultation Form - Required

Download & Print Form  


Personal Injury Questionnaire - Required

Download & Print Form


Lifestyle Questionnaire - Required

Download & Print Form


Exercise Prescription Form - Optional

Download & Print Form


Update Your Health History

Download & Print Form


DASH Form

Download & Print Form


Back Index Form

Download & Print Form


Neck index Form

Download & Print Form


Lower Extremity Form

Download & Print Form



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