New Patient Paperwork

Pinnacle Physical Medicine and Rehab offers our patient form online so they can be completed in the convenience of your own home or office.

  • New Patient Paperwork

    Click to Complete

The below forms are PDF files for you to download, print, and complete before your appointment.

  • All forms are PDF files. You will need AdobeReader® to view them.
  • If you do not already have AdobeReader® installed on your computer, Click Here to download.
  • Download the necessary form(s), print them out, and fill in the required information.
  • Bring your printed and completed form(s) with you to your appointment.
  • Confidential Patient Information

    Click to Download

  • New Patient Paperwork

    Click to Download

  • Financial Policy

    Click to Download

  • HIPPA Policy

    Click to Download

  • George's Cerebrovascular Craniocervical Function Test

    Click to Download

New Chiropractic Patients To Our Office Only


8:30am - 6:00pm

2:00pm - 6:00pm

8:30am - 6:00pm

2:00pm - 6:00pm

8:30am - 12:00pm

Saturday & Sunday

*Please call before walking in to make sure we have room to see you.

Pinnacle Physical Medicine and Rehab

2605 Jenkins Rd #2
Chattanooga, TN 37421

(423) 855-5053