Please click on the "underlined" forms
below, complete form, print, and bring with you to your first
visit. There are two versions
of each form. One to print and complete with pen and a "fill in"
version for those with Microsoft Word to type and print
New Client(s)
Current or Returning Client(s)
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Physical Therapy Form:
Please arrive to your appointment 10-15 minutes
early to complete forms and prepare for your therapy visit or
download and bring with you.
Massage Form:
Adobe /
fill in format
Please arrive to your appointment 10 minutes
early to complete forms and share your goals with the therapist
or download and bring with you.
Direct Access is the opportunity for evaluation and
treatment by a licensed Physical Therapist without a referral
from your physician. This saves time and money, thereby
expediting treatment, relief and recovery. Some insurance
carriers require a physician referral, but we can work with you and your
physicians to get necessary paperwork completed.
"In-Network" Insurance Carriers:
We are contracted with
many carriers for "in-network" coverage. We may verify
coverage, but do not guarantee that we are "in-network" on every
plan by these carriers. If you have concerns, please
contact your carrier to ensure "in-network" or therapy coverage
exist on your plan.
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This form should be completed
by all returning patients (not seen in last
3 months) for your first returning visit.
This form
should be completed
before your second
therapy visit and after
your last therapy visit.
Your therapist may ask
you to complete it at other
times also to aid in
your treatment and
assessment.
Cancel / No Show Policy
Your time and our
time is
valuable. If you are
unable to make your
scheduled appointment
time,
please give 24 hours
notice so someone
waiting may be seen.
Doctors need more script pads!
Click here and we'll send them right over.
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HIPAA Privacy
Notice Form:
This form describes how health
insurance information about you, as a patient of this
practice, may be used and disclosed. This is required by the Privacy
Regulations
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