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New Patient Forms

Patient Forms

Patient Information 1(591.52 KB)
Patient Information 2(521.51 KB)
Patient Information 3(477.59 KB)
Activities Discomfort Scale (PDF)(73.76 KB)
Activities Discomfort Scale (PDF)
Oswestry Neck Disability Questionaire(522.87 KB)
The Copenhagen Functional Disability Scale(330.02 KB)
The Quebec Back Pain Disability Scale(33 KB)
Roland Morris Low Back(1.94 MB)
Oswestry Low Back Disability Questionaire(529.99 KB)
Pain Drawing(214.82 KB)
Pain Drawing
Auto Accident History 1(589.61 KB)
Auto Accident History 2(543.95 KB)
Workers Compensation Page 1(609.4 KB)
Workers Compensation Page 2(588.36 KB)

Exercise Forms

Cervical Spine Hand-Resistance Exercises(151.5 KB)
Cox® Cervical Spine Hand-Resistance Exercises
Cervical Spine Band-Unit Resistance Exercises (682.51 KB)
Cervical Spine Band-Unit Resistance Exercises
Proprioception Exercises(694.19 KB)
Proprioception Exercises with and without a stability ball
10 Basic Low Back Exercises(971.61 KB)
10 Basic Low Back Exercises - no equipment necessary
Low Back Pain Exercises with a Stability Ball (318.33 KB)
Low Back Pain Exercises with a Stability Ball
"This information and website content is not intended to diagnose, guarantee results, or recommend specific treatment or activity. It is designed to educate and inform only. Please consult your physician for a thorough examination leading to a diagnosis and well-planned treatment strategy. See more details on the DISCLAIMER page. Content is reviewed by Dr. James M. Cox I."