Online Forms

Initial Evaluation Forms

Prior to your first appointment, we ask that all of our patients fill out a Consent Form. After you schedule your first appointment, you will be emailed an intake survey asking about pain levels and difficulty with activities, etc. Please fill this out prior to your appointment as this helps streamline our therapists initial evaluation.

If you wish to book your appointment online, please use your full, legal name. If you have been a patient in the past with Dubuque Physical Therapy, we ask that you also please use the same date of birth, name and phone number you have used in the past. This helps prevent duplicates. Thank you!

Please complete prior to your first appointment.

Additional Forms

Please complete prior to Laser Therapy.

Please complete prior to Dry Needling Therapy.

Tri-State Running Series

“Training to Run” and “Training to Perform”