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Online Forms

PSS Injury & Wellness Center offers our patient form(s) online so they can be completed it in the convenience of your own home or office.

  • If you do not already have AdobeReader® installed on your computer, Click Here to download.
  • Download the necessary form(s), print it out and fill in the required information.
  • Fax us your printed and completed form(s) or bring it with you to your appointment.


New Patient Health History Form - Required

This lets us know the history and current state of your health. What questions, concerns, goals, regarding wellness can we help you with? Let us know!  Since various health insurance carriers have their own specific forms, please choose from below:

Download & Print Forms for United Health Care  Insurance Patients

Download & Print Forms for Great West Insurance Patients

Download & Print Forms for Blue Cross / Blue Shield Patients

Download & Print Forms for Humana Insurance Patients

Download & Print Forms for ALL OTHER HEALTH INSURANCE Patients

Download & Print Forms for Cash Patients (no insurance)

Download & Print Forms for Patients Have Been In An Automobile Accident or other Personal Injury 



Download the Free AdobeReader®