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:

• New Patient Forms
• Direct Access Form (only needed if you have not seen a physician for your injury /condition within the past 60 days)

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

• Elbow, Shoulder, or Hand
• Neck Pain
• Low Back Pain
• Hip, Knee, Ankle, or Foot
• Dizziness

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:

• Notice of Privacy Practices
• Financial Policy

Medical Records – Please complete the form below and contact our office at 540.772.8022 or medicalrecords@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.

• Release of Medical Records