(502) 245-0767
info@myockn.com

The Family Center for Health and Wellness

 

New Client Paperwork & Information

Adult New Patient Paperwork - Fill out Form

Neck Assessment - Fill out form

Back Assessment - Fill out form

Lower Extremity Assessment - Fill out form

Headache Assessment - Fill out form

Upper Extremity Assessment - Fill out form

Thank you for being a client at Occupational Kinetics & The Center for Alternative Medicines.  We strive to give you the signature experience in our facility. 


Please fill out the information necessary for us to bill your insurance company and to find out a history of you before your treatments.


If you have any symptoms that relate to:


  1. 1.Neck

  2. 2.Back

  3. 3.Lower Extremity (Anything from the waste down.)

  4. 4.Headaches

  5. 5.Upper Extremity (Shoulder, Arm, Elbow, Hand)


Please fill out the form that applies to your condition as well as the New Patient Paperwork.

Pediatric New Patient Paperwork - Fill out Form

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