New Patient Forms

Video Health Care Consent Form

For video health care, please fill out the following form. If you are a new patient of Wefixu, please also fill out the “New Patient Registration Form” below. 

Instructions: Click the button below to fill out the form online. If you are using a mobile device, please click the “Continue in Browser” or download their app to continue. It is recommended to fill out the forms on desktop as it is easier. Your information is 100% confidential and safe.

New Patient Registration Form

For new patients, please fill out the following form and bring it to your first appointment. 

You could fill it out in online or by paper:

Online: Click the button below to fill out the form online. If you are using a mobile device, please click the “Continue in Browser” or download their app to continue. It is recommended to fill out the forms on desktop as it is easier. Your information is 100% confidential and safe.

Physical Copy: Download the form, print, fill it out, and bring to your first appointment. 

New Patient Registration Form (Print).

New Patient Instruction Manual

All New Patients please download and read our Patient Instruction Manual. The information inside will help you achieve better results and answer a lot of questions about treatment processes. Click on the image below to download.

Patient Outcome Measure Questionnaire

Please download the form onto your computer, fill it out, and send it back to your therapist via email.

Roland Morris Questionnaire

Quick Dash

Lower Extremity Functional Scale

NDI (Neck Disability Index)

PSFS (Patient Specific Functional Scale)

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