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Physical Medicine and Family Welllness Center, LLC offers our patient form(s) online so they can be completed it in the convenience of your own home or office.

  • If you do not already have AdobeReader® installed on your computer, Click Here to download.
  • Download the necessary form(s), print it out and fill in the required information.
  • Fax us your printed and completed form(s) or bring it with you to your appointment.


New Patient Health History Form - Required

This lets us know the history and current state of your health. What questions, concerns, goals, regarding wellness can we help you with? Let us know!

Download & Print Form


Member Wellness Registration Form - Optional

This form can be filled out to register for access to the member wellness section of our website. You can also sign up for our monthly newsletter to keep up on current health issues and news and events in our office. You can print it out and bring it in to our office or Click Here to register online! The online newsletter sign-up is also on the right. We look forward to making your experience with our office and website more interactive and rewarding!

Download & Print Form


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Office Hours

Day
Mondayclosed
Tuesday11:00am7:00pm
Wednesday9:00am6:00pm
Thursdayby appointment
Friday9:00am6:00pm
Saturday8:30am11:30am
Sundayclosed

Call Us:
203-426-6334
Request
Appt.

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3D Spine Simulator


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Contact

Physical Medicine and Family Welllness Center, LLC
24 Glen Road
Sandy Hook, CT 06482
Get Directions
  • Phone: 203-426-6334
  • Fax: 203-426-3070
  • Email Us

Newtown Earth Day Festival

Come and celebrate Earth Day with us on Saturday, April 28th at the Newtown Middle School, 11 Queen Street from 10 - 4pm. Stop by and say hello at our vendor table where we will be doing free 100 point wellness inspections with our new NRG Nano Stress Reduction Therapy System!

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