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NEW Patient Advanced Check-In 
 

If You Are In A Lot Of Pain Right NOW, Call Us Directly At 414-425-9700. We'll See You Right Away.

Send us your information right now. Save time by filling in the quick form below. Please don't forget to give us your preferred appointment times along with the location most convenient for you, and we'll call to confirm.

Thank You

Please fill in the form below if you would like to book a free screening or begin the Advance Check-in process for new patients. After submission, you will be notified by phone or email to confirm your appointment time.

Please DO NOT fill in this form if you have already phoned for an appointment.

Patient Information
First Name:
 *
Last Name:
 *
Daytime Phone
 *
Email Address:
Address:
 *
City:
 *
State:
 *
Zip Code:
 *
I am requesting:
Referring Physician
Problem Description & Preferred Appntmnt Times
Problem
Notes & Times Preferred:
Do not enter anything in this field:
* indicates a required field

 

Save even more time by printing off and filling out your paperwork before you come in.  Our waiting rooms are nice, but we are sure you don't want to spend any more time in them than you absolutely have to. 

Download Intake Forms





Patient Intake Forms

Convenient Hours & 
Locations

Franklin Rehabilitation
7253 South 76th Street
Franklin , WI. 53132
Phone: 414-425-9700
Monday, Wednesday & Thursday
9:00am to 7:30pm
Tuesday & Friday
9:00am to 5:00pm

Innovative Physical Therapy & Sports Medicine
(Located inside Innovative Health & Fitness)
8800 South 102nd St.
Franklin , WI. 53132
Phone: 414-448-3097
Monday-Thursday
8:00am to 7:30pm
Friday
8:00am to 5:00pm


    

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