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New Patient Intake Form

Thank you for taking the time to complete the intake forms online.

To prepare for your visit, please review the following:

  1. Please allow +/- 30 minutes from the time your appointment is scheduled to allow for scheduling and travel disruptions. Every attempt will be made to honor the scheduled time. Dr. DeFries will contact you prior to arriving and if he anticipates a change in the time.
  2. An area of about 8x5 feet is needed.  A portable table will be set up that is 5 1/2 feet long by 3 feet wide.  It is best to set the table up next to a sofa or chair.
  3. Nearby access to an electrical outlet is preferred.
  4. Please secure any aggressive pets. 
  5. If you prefer having someone else present, please be sure to have them at the appointment location at the requested time.
  6. Please wear loose-fitting clothing. Where the pain is is often not where the problem is... the body is one unit and a complete examination requires inspection of many parts. Clothing should allow free movement and access to the spine, legs, arms, shoulders, and pectoral area. 
  7. Physical medicine often requires addressing and contact with areas some deem sensitive. Dr. DeFries is keenly aware of this and acts accordingly. Should you, at any time, feel uncomfortable, please alert Dr. DeFries so that particular treatment can be stopped.
  8. Be aware that it is common for some treatments to cause tenderness, bruising, redness, or soreness. If you experience any unusual symptoms after treatment please contact Dr. DeFries immediately.