Patient Treatment forms

Patient Information

Assessments

Insurance

Privacy

Patient Information Forms

Forms in this section are for your first visit or when you need a re-assessment.

PATIENT INFORMATION

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PATIENT INFORMATION SHEET

Size: 97.17 KB
Date modified: 21-04-2020
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PATIENT HISTORY

Size: 106.54 KB
Date modified: 21-04-2020
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INTAKE PAPERWORK

Size: 60.80 KB
Date modified: 21-04-2020
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FUNTIONAL SKILLS

Size: 49.91 KB
Date modified: 21-04-2020

Assessments

Forms relating to assessing your current physical condition are located in this section.

ASSESSMENTS

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NECK DISABILITY FORM

Size: 50.22 KB
Date modified: 03-06-2020

Insurance

Forms relating to your insurance coverage are located in this section.

INSURANCE

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ASSIGNMENT OF INSURANCE

Size: 37.96 KB
Date modified: 21-04-2020

Privacy Statement

Forms relating to the Lee Miller Rehabilitation Privacy Policy are located in this section.

PRIVACY

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NOTICE OF PRIVACY PRACTICES

Size: 104.00 KB
Date modified: 21-04-2020

Get in Touch

Catonsville: (443) 860-9168
Catonsville Fax: (443) 636-5987

Owings Mills: (410) 363-0015
Owings Mills Fax: (410) 356-7763

info@leemillerrehab.com

 

Open Hours

Mon - Fri — 8:30am - 6:00pm
Saturday — 8:30am - 6:00pm
Sunday — 8:30am - 1:00pm

Lee Miller Rehab - Catonsville

2 East Rolling Crossroads, Ste 57
Catonsville, MD 21228


Lee Miller Rehab - Owings Mills

20 Crossroads Drive, Ste 13
Owings Mills, MD 21117

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