Every new patient at WellCare Medical in Bradford completes intake forms before their first treatment. They give your clinician the background needed to assess you safely and plan the right care, whether you are coming for physiotherapy, chiropractic treatment, massage therapy, acupuncture or custom orthotics.
What the intake forms ask
- Your contact details and an emergency contact
- Your health history: past injuries, surgeries, medical conditions and allergies
- Current medication, including blood thinners and over-the-counter products
- The reason for your visit: where it hurts, when it started and what makes it better or worse
- Your goals: what you want to be able to do again
- Insurance information, if you would like us to bill your plan directly
- Consent to assessment and treatment
Answer as fully as you can. Something that seems unrelated, such as a medication or an old injury, can change which treatments are suitable for you.
Getting the forms
Plan to arrive a few minutes early for your first appointment so there is time to complete your forms without feeling rushed. If you would prefer to fill them in before you arrive, call (365) 247-0440 or email us and ask the front desk about receiving them ahead of time.
What to bring to your first visit
- your benefits card or insurance policy and member numbers
- a doctor's referral, if your insurance plan requires one
- a list of your medication
- any X-ray, MRI or ultrasound reports related to your problem
- for a car accident claim: your claim number and your adjuster's name and contact details
- comfortable clothing that lets you move and gives access to the area being treated
- orthotics, braces or supports you currently use
- the shoes you wear most often, if you are coming about foot, knee or hip pain
After a car accident: what changes
If your visit follows a motor vehicle accident, there are additional insurance forms. Our team completes these with you and submits them to the insurer. Read more about car accident rehabilitation.
How we protect your information
Your intake forms are part of your health record. They are kept confidential and are used only to provide and bill for your care, as set out in our privacy policy. You can ask to see your record or correct it at any time.
What happens at the first appointment
Your clinician reads your forms, asks follow-up questions, carries out a physical assessment and explains what they found. Treatment usually starts at the same visit. For more on what to expect, see our frequently asked questions and patient education pages, or check location and hours before you set out.
Common questions about patient intake forms
Can I fill in the forms for a family member?
A parent or guardian completes the forms for a child. For another adult, please ask them to complete their own forms, or to attend with you if they need help.
Do I need to complete new forms for each type of treatment?
Your core information is collected once. A clinician may ask a few additional questions that are specific to their treatment.
What if my health or medication changes?
Tell your clinician or the front desk at your next visit so your record stays up to date.