This section includes two Case History forms. These forms will provide therapists with preliminary background information for clients scheduled to use our services. Forms can be printed and completed at your convenience prior to your first appointment, or we ask that you arrive 10 – 15 minutes early for your initial appointment to allow sufficient time to complete the forms.
The General Case History Form is needed for all clients attending appointments at Salutaris. Clients seeking treatment for lymphedema should also fill out the Lymphedema History Form, also found in this section.
Please be as thorough as possible. If you have any questions concerning the information you are asked to provide, your therapist will be pleased to assist you.
Download and print form(s) below:
- General Case History Form
- Lymphedema History Form