Forms | handsonhands

top of page

Hands On Hands Rehabilitation Center, Inc.

"Comprehensive Upper Extremity Rehabilitation Center"

We pride ourselves
in
providing the
best quality of
Hands on Treatments
with
Professional Skilled Therapists

To schedule an appointment:

Call one of our four locations:

Costa Mesa 714-556-2288

Huntington Beach 714-842-6202

Los Alamitos 562-430-8700

Laguna Hills 949-470-0021

Forms

We ask you to please print out the following forms and complete prior to your initial visit. Please bring completed forms with you along with your doctors prescription, your identification card, your insurance card, and any additional information provided by your doctor and We look forward to working with you in your recovery.

Patients Forms:

Registration Form

Health History and Medications Forms

Financial Contract, Cancellation and No Show Policy

Notice of Privacy Practices

Upper Extremity Functional Index

Medicare Reporting Index Medicare Patients Only

Spanish Forms: Registration Form

Spanish Forms: Financial, Cancellation and No Show Contract

Spanish Forms: Notice of Privacy Practices

Spanish Forms: Health History and Medication Form

Spanish Forms: Upper Extremity Functional Index

Spanish Forms: Medicare Reporting Index Medicare Patients Only

Hands On Hands Rehab Prescriptions

Hands On Hands Brochure

bottom of page