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The Center for Rehabilitation and Sports Medicine

History Forms

Prior to your first visit to rehab and to save time during your registration process, please complete the appropriate history form linked below. Please bring the completed form with you when you come for your first visit.

Outpatient History Questionnaire for Adults

Outpatient History Questionnaire for Children

Audiology History Questionnaire for Adults

Audiology History Questionnaire for Children

Audiology History Questionnaire for Infants

Speech History Questionnaire for Adults

Speech History Questionnaire for Children

Awards & Recognition

100 TOP HOSPITALS

Beverly Hospital and Addison Gilbert Hospital Among Truven Health Analytics 2015 Top 100 Hospitals

THE LEAPFROG GROUP'S HOSPITAL SAFETY SCORE

Since the onset of the Hospital Safety Score in Spring 2012, the publicly available data showed Beverly Hospital and Addision Gilbert Hospital have consistently exceeded the standards of other medical institutions in terms of patient safety procedures in place, earning them both a Straight A’s distinction.

Our Boston Area Locations

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