Forms

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Prior to your initial visit or during your treatment, Julie may request that you complete some documentation to help reduce the amount of time during her visit and help her better assess how to treat you. Please download and complete the appropriate form below, based on your condition. If you have any questions regarding which form to use or how to complete it, contact Julie.

Client Documentation

Patient History

Pelvic Floor Rehabilitation – Pediatrics

  • Pediatric Consent for Evaluation & Treatment (download coming soon)
  • Pediatric Health History & Screening Questionnaire (download coming soon)
  • Daily Bladder Log (download coming soon)
  • Your Bladder Instructions(download coming soon)

Lymphedema

  • Lymphedema Patient Questionnaire (download coming soon)