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Forms

September 20, 2010

I have an appointment, which forms do I complete?
I am a New Patient.
I am a New Pediatric Patient (0-18 years of age) being seen by Dr. Bret Baynham.
I am a New Pediatric Scoliosis Patient (0-18 years of age) being seen by Dr. Bret Baynham.
I am a New Patient being seen by Dr. Clay Baynham.
I am a Returning Patient.
I am a Returning Patient but am being seen for a new injury.


Application for Employment
If you are interested in advancing your career in a challenging, fast paced environment, fill out our Application for Employment and fax the completed form to (561) 727-1203.
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HISTORY FORMS 

Follow Up
If you are currently being treated at PBOI, fill out the Follow Up form and bring it with you to your next appointment to expedite your check in process.
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New Patient
If you are a new patient, are being seen for a new problem or have not been seen in our office in the past 3 years, fill out the New Patient form and bring it with you to your next appointment to expedite your check in process.
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New Patient Pediatric (Dr. Bret Baynham)
If you are a new pediatric patient (0-18 years of age) being seen by Dr. Bret Baynham, fill out the New Patient Pediatric form and bring it with you to your next appointment to expedite your check in process.
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New Patient Pediatric Scoliosis (Dr. Bret Baynham)
If you are a new pediatric scoliosis patient (0-18 years of age) being seen by Dr. Bret Baynham, fill out the New Patient Pediatric Scoliosis form and bring it with you to your next appointment to expedite your check in process.
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New Patient (Dr. Clay Baynham)
If you are a new patient being seen by Dr. Clay Baynham, fill out the New Patient form and bring it with you to your next appointment to expedite your check in process.
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Medical Records Release Form
If you are requesting medical records, it is required by law the Medical Records Release Form be filled out and returned to our Medical Records department prior to the release of your records.
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PHYSICAL THERAPY FORMS 

Registration
Ask your Physical Therapist if this is the right form for you to fill out.
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Lower Extremity Functional Scale
Ask your Physical Therapist if this is the right form for you to fill out.
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Low Back Pain Questionnaire
Ask your Physical Therapist if this is the right form for you to fill out.
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Neck Disability Index
Ask your Physical Therapist if this is the right form for you to fill out.
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Shoulder Functional Assessment Questionnaire
Ask your Physical Therapist if this is the right form for you to fill out.
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