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New Patient Forms

Completing forms ahead of time makes your first visit quick and efficient!

Prior to your appointment please complete the forms below and bring them with you on your first visit along with your insurance card(s), Photo ID, and referral.

We prefer you use the patient portal , but if you would like to print our forms as a PDF you can do so below:

Outcome Measures
If you are a new patient, please download the form that best corresponds to your injury:

Lucas Therapies is committed to maintaining the privacy of your personal health information. In compliance with the latest HIPAA regulations, our full Notice of Privacy Practices can be found here:

Medical Records – Please complete the form below and contact our office at 540.772.8022 or info@lucastherapies.com to request your records.  You may also upload a singed copy of the release form utilizing the upload button at the top of this page.

Credit Card on File

Please complete the form below if you wish to set-up an automatic payment plan. You may upload a singed copy of the form utilizing the upload button at the top of this page.

Upload Your Patient Forms