Forms

The following forms and physician information
refer to the Forms section found in
Work-Related Low Back Pain “The New Paradigm”

Staff Forms Patient Forms - Initial Visit Special Note: Depending on the physician’s preference the next two questionnaires can either be completed by the injured worker before the patient is seen or the forms may be placed in the chart for the physician to complete or have the injured worker complete during the conclusion of the initial visit. Patient Forms - Second Visit Two Week Re-Evaluation Supplemental Patient Questionnaires
The following are additional questionnaires that may be used instead of others listed above. Should you prefer one of these forms, repeat at two weeks to make certain that you are capable of determining patient progress by using the same form(s). Physician Forms Return to Work Forms
These forms are used when the nurse case manager or vocational rehabilitation specialist are assisting the injured worker in returning to the job of injury or finding a new job within his physical limitations. Physician Information Calculating Patient Questionnaires Home CBT, Desensitization, Activity, and Exercise Forms Chapter 8 Forms
(partial list related to initial contact with injured worker, employer, insurer, as well as, patient and physician forms related to return to work)

In full compliance with copyright laws, external
links are provided for some of these forms.

When we address "Copyright Infringement" and " "Fair Use".
Copyright Infringement Claim Form