Forms                  

 

Please Be Here 15 Minutes Prior to your scheduled appointment, especially if you have not completed filling out your paperwork.

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Medicare

Patient Forms - Download / Print and fill out forms prior to your first physical therapy appointment. Also See Fig. 1 below

Medicare Form 1 - Download / Print and fill out forms prior to your first physical therapy appointment.

Also Complete Forms on Fig. 1 below

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Workers Comp

New Workers Comp Patient - Download / Print and complete it prior to your first physical therapy appointment. 

FCE Packet - Download / Print and complete it prior to your appointment. ONLY USE if your Doctor has ordered a Functional Capacity Evaluation.

Also Complete Forms on Fig. 1 below

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All Other Insurance

Patient Forms - Download / Print and fill out forms prior to your first physical therapy appointment.

Also Complete Forms on Fig. 1 below

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Fig 1.

 

Also, you will need to fill out form(s) related to the area(s) of injury.  Please click on those areas below.  Print and fill out all forms prior to your visit.

 

Spanish Version Below:

If you are seeing us for a hip, thigh, hamstring, knee, calf, shin or ankle/foot, then fill out the Spanish Version

For the shoulder, upper arm, lower arm or hand, fill out the: Spanish Version

For the back, fill out the Spanish Version and for the Neck, fill out the Spanish Version

United health care patients need to fill out the:
Spanish Version