Locations: Upper Perk | New Hope | Springfield
(215) 679-0105
Jay.Kauffman@UpperPerkPT.com
Upon arrival at our facility a licensed therapist evaluates all patients to establish a baseline used to track progress. This includes a medical history, musculoskeletal evaluation, and professional assessment of the affected area. Goals will then be discussed with the patient and referring physician. Together, the patient and therapist will mutually decide on a convenient treatment schedule.
Print and fill out the forms below before you arrive to save time in the waiting room.

Medical Questionnaire and Medication History Form (.pdf format)
Consent Form (.pdf format)
Patient Data Sheet (.pdf format)
HIPAA Policy (.pdf format)
Massage Client Intake Form (.pdf format)

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