Coppersmith

Orthopedic & Sports Physical Therapy

5025 25th Ave NE #201

Seattle, WA 98105

P: 206-524-6702   F: 206-524-6703

coppersmithpt@gmail.com

To expedite your first visit, please print out the following PDF forms. Please bring the completed forms along with your insurance information with you at your first visit.

If you have any questions, we would be happy to assist you when you come in.

We would also like you to complete a diagnosis related questionnaire to be used to follow your rehab progress. Please select the diagnosis that applies to you, print and complete the form, and bring to your appointment.

Privacy Statement

Please read our privacy statement, as mandated by federal law for your protection. You will be asked to sign an acknowledgement at your first appointment. A copy is available, if you so desire.

"Figures in Motion" copyright COSPT, Designed by Leo Posicillico (www.leoposillico.com)

Site design by Chloe Wilkes.