Appointments:

Important Forms

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Patient Forms

• New Patient Packet
  To be filled out by all new patients.
• Patient Payment Information
• Patient Registration
  Contains all critical contact and insurance information.
• Patient Insurance Form
• Insurance Benefits Worksheet
  A personal worksheet to help you determine your physical therapy health insurance benefits. Please fill this out before your first visit.
• Patient Consent and Release of Medical Benefits Authorization
• Initial Evaluation Intake Form
  To be filled out by the patient before the initial visit. This form addresses the current issue or injury to be treated.
• Authorization for Release of Info
  To be filled out and signed by the patient in order for our office to request records/operative notes/imaging studies from another health provider.
• Notice of Privacy Practices