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TIMOTHY L. FAGERSON, DPT Doctor of Physical Therapy

SOS: Help for Spine, Orthopaedic & Sports Injuries
Timothy L. Fagerson, DPT
SOSPT Rx Philosophy
Payment Policy
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AlterG Anti-Gravity Tread
Restore, Maintain, Enhance 
SOS-PT Patient Forms

Below are the intake forms that you will need to fill out prior to your first visit.

Please bring these completed forms to your Initial Evaluation with Dr. Fagerson.

Alternatively, we can fax these to you or you can arrive 15 mins early to fill them out.

1. Personal Information Form

2. Heath Status Questionnaire

3. Pain Drawing Form

4. HIPAA Form


Condition Specific Scores: Dr. Fagerson may request that you complete one of the scores from this link: