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Sports Injury Rehab Intake Form

Sports Injury Rehab Intake Form

Assess new rehab clients and their injury history, capturing the injury, pain, and goals in one thorough intake form.

Description

The Sports Injury Rehab Intake Form gives rehab professionals a thorough way to assess a new client. It captures the main injury or area, where it hurts and the pain level now, when it started, and how it happened, so you understand the injury before the first session.

Fields for whether they have seen a doctor or had a scan, relevant medical history, what activities are limited, and their main goal build a clear picture, while a consent step and contact details complete the intake. Capturing all this upfront means safe, targeted rehab from day one.

A thorough assessment is the start of recovery. Sign up for a free Fun Forms account to customize the fields and embed this intake form on your website.

Form fields

Everything the Sports Injury Rehab Intake Form above collects — 14 fields across 3 pages, so you can see exactly what it captures before you make it your own.

Start Your Recovery

What's the main injury or area?
Short Answer
Where does it hurt? (area, pain now (0–10), when it's worst)
Table
When did it start?
Date
How did it happen?
Dropdown
Have you seen a doctor or had a scan?
Yes/No
If yes, what did they say?
Long Answer

History & Goals

Any relevant medical history or past injuries?
Long Answer
What activities are limited right now?
Long Answer
What's your main goal for rehab?
Long Answer
Have you done rehab or physio before?
Dropdown

Your Details

Your name
Name
Email address
Email
Phone number
Telephone
Consent to assessment
Consent

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Template FAQs

Common questions about the Sports Injury Rehab Intake Form — what it captures, when to use it, and how to make it your own.

What is a sports injury rehab intake form?

A sports injury rehab intake form is an online form used to assess a new rehab client. It captures the injury, pain, history, and goals, so a professional can understand the injury and plan safe, targeted rehabilitation from the first session.

Why ask about pain levels and when it’s worst?

Pain levels and when the injury hurts most give a clear picture of severity and behavior. Capturing them helps you gauge the stage of the injury, track change over time, and plan rehab that respects pain rather than pushing through it, keeping recovery safe.

Why ask if a client has seen a doctor or had a scan?

Knowing whether a client has had medical assessment or imaging tells you what is already known about the injury. It helps you work alongside any diagnosis, avoid overstepping your scope, and plan rehab appropriate to the professional guidance they have received.

Why capture relevant medical and injury history?

Past injuries and medical history give essential context, revealing patterns, weaknesses, or conditions that affect recovery. Knowing them helps you plan rehab that addresses the whole picture and avoids aggravating anything, so the client recovers safely and reduces the risk of recurrence.

Why ask about the client’s rehab goal?

Knowing a client’s main goal, whether returning to sport, daily activity, or being pain-free, keeps rehab focused and motivating. It helps you set meaningful milestones and tailor the plan toward what matters to them, so they stay engaged through their recovery.

Is the sports injury rehab intake form free?

Yes, this sports injury rehab intake form is completely free, and you can customize the fields to fit your practice, embed it on your website, and go live with no coding required. Just create a free Fun Forms account to start assessing clients online.

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