Welcome

We’re here to help

Thank you for booking an appointment with The Hands Physio. I am so pleased to help you recover from your injury and return to your optimal ability.
The Hands Physio provides excellence in Diagnosis, Education of your Injury and Customised Treatment Programs.  I believe in helping you become an active participant in your recovery from injury, providing you with the most accurate published information about your condition and then tailor making a treatment program to assist you in the recovery of your injury.
We look forward to meeting you in person and taking you through this journey to see you recover as a champion!

Please call 02 97434672 or click on BOOK AN APPOINTMENT tab above to make an appointment!

Kind regards,

Rebecca Farr

Founding Director
Accredited Hand Therapist
B.App.Sc. (Physio) (Hons)
‍

Patient Information
Full Name*
Is the patient under 21 years of age?*
Gender*
Phone Number*
Date of Birth*
Email Address*
Home Address
Injury Description
​​Approximate Date of Injury
Brief Injury Description
Side
If you required surgery for this injury: Please give details of when, where and what type of surgery.
GP Name & Phone Number
Surgeon Name & Phone Number
Financial
Private Health Fund Name
If Workers Compensation or CTP: Please provide Insurance details and Claim number.
General Health
If yes, please provide details below.
Do you have diabetes?​
Do you have a pace maker?
Do you have a heart condition?
Have you had a blood clot, thrombosis or stroke?
Do you suffer from asthma?
Have you ever been a smoker?
Have you ever been diagnosed with an infectious disease or cancer?
Are you pregnant?
Details
If you suffer from any allergies, please provide details
Please provide details of your current medications
Informed Consent
By typing my name below, I confirm that I have read and understood the above statements.
I understand that permission from a parent or custodian is required to treat a minor.
First Name*
Last Name*
How did you hear about The Hands Physio?
Thank you
We will get back to you shortly!
Oops!
Something went wrong while submitting the form.