THESE FORMS DO NOT SUBMIT ELECTRONICALLY. YOU MUST PRINT OUT AND BRING WITH YOU TO YOUR APPOINTMENT.

If you are a new patient and have scheduled your first appointment with one of our physicians:

Please read our Patient Policies prior to your first appointment as you will be asked to electronically sign an acknowledgment of these policies: Northeast Rehab Patient Policies

Please choose the appropriate packet for your type of appointment to complete and prior to your first appointment:

• • New Patient Evalulation Packet - PDF
  • Medical Marijuana Evaluation Packet - PDF
  • Concussion Evaluation Packet - PDF
  • EMG Evaluation Packet - PDF

Please also review these additional notices:

• PA PDMP
• KeyHIE
• Beneficiary Info Notice/ACO
• Establishing Care/Team Approach
• HIPAA Privacy Policy