Our mission is to Provide Excellence in Rehabilitation Care.

6400 College Drive – Suite 800
Palos Heights, IL 60463
Phone (708) 489-6777
FAX (708) 489-6303
info@prorehabpt.org

9518 W. 179th St.
Tinley Park, IL 60477
Phone (708) 633-0600
FAX (708) 489-6303
info@prorehabpt.org

 

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Forms

Click on a title to open, and then click on the title link to open and export PDF file to your desktop.
New Patient Form Privacy Statement Referral Intake Form
Click on a title to open, and then click on the title text link to open and export the PDF file to your desktop so you can print, fill it out, and bring it to your appointment.
Quick Dash Form Neck Index Form Lower Extremity Functional Scale Back Index Form
forms

Forms For Your Appointment

For your convenience, we have included our patient forms. You can fill out the form, directly on your computer, and email it to info@prorehabot.org. Your other option is to print the forms, complete them, and bring them to your next visit.

forms

Forms For Your Appointment

For your convenience, we have included our patient forms. You can fill out the form, directly on your computer, and email it to info@prorehabot.org. Your other option is to print the forms, complete them, and bring them to your next visit.

Click on a title to open, and then click on the title link to open and export PDF file to your desktop.
New Patient Form Privacy Statement Referral Intake Form
Click on a title to open, and then click on the title text link to open and export the PDF file to your desktop so you can print, fill it out, and bring it to your appointment.
Quick Dash Form Neck Index Form Lower Extremity Functional Scale Back Index Form

Do You Have Questions About These Forms? Contact Us Today And We Will Help You Get Prepared For Your Appointment