Your pelvic floor evaluation is booked!
Thank you for booking your evaluation with us! We look forward to assisting you on your journey to better health and wellness. To ensure we have all the necessary information for your evaluation, please complete the intake paperwork provided below.
Please complete and submit the intake paperwork at least 48 hours before your scheduled evaluation.
You will have access to this page via the link in your booking confirmation. Consider bookmarking this page for easy access in the future.
Intake Paperwork - Complete Before Your Evaluation
Contact Information and Medical History Form
This form collects your basic contact information, medical history, pelvic health-related history, and current complaints.
Pelvic Health Questionnaire
This questionnaire is specific to pelvic health conditions and will help us better understand your symptoms and needs.
Central Sensitization Inventory
A quick questionnaire to assess central sensitization, which may be relevant to your condition.
Payment and Cancellation Policy
Please review our payment and cancellation policy to understand our terms and conditions.
Preparing for Your Evaluation
Since evaluations will take place in your home, please choose a location that is free from distractions and has comfortable seating for two. Consider a space where you will also have the ability to lay down for certain portions of the evaluation.
Wear comfortable, loose-fitting clothing that allows for easy movement.
Ensure all intake paperwork is filled out, and if requested by your therapist, complete a bowel/bladder log.
Contact Us
If you have any questions or need assistance with the paperwork, please do not hesitate to contact us:
Phone: 770-376-5455
Cancellation Policy
As mentioned in your cancellation policy linked above, if you need to reschedule or cancel your appointment, please notify us at least 24 hours in advance to avoid any cancellation fees.
We look forward to meeting you and helping you achieve your health goals!