Supporting our patients during the COVID-19 response
Patient Intake Forms
At Franklin Rehab, we want to maximize your time with us. Prior to your first visit, please follow the steps below:
In-Clinic or At-Home Visit:
Click on the applicable form below, fill out and submit online.
New Evaluation Form – English / Spanish
Virtual Visit:
Click on the applicable forms below, fill out and submit online.
New Evaluation & Consent Forms
Existing Patient Virtual Visit Consent
Notice of Privacy Practices
Notice of Privacy Practices – English / Spanish