To Get Started
When you come in for your first physical therapy appointment we will be asking you to fill out some paperwork.
Don’t worry! We have done everything we can to keep the paperwork to a minimum. It only takes about 5 minutes or so to complete.
Make Your First Physical Therapy Appointment Easier
If you would like to save some time you can print and complete the paperwork before you come in.
Doing so not only saves time… It adds time to your actual visit. Time you can use to ask questions or get some additional treatment time.
Thanks But No Thanks
If you are unable to or just prefer not to complete these forms before you come in – No problem! You can simply fill them out when you get here. If you plan to do this we suggest you get to your appointment about 5 minutes early to complete the paperwork (so it doesn’t cut into your physical therapy appointment time).
The Paperwork – For General Health Insurance
If you will be using your health insurance (or if you are a cash patient) you’ll need to complete the following forms
New Patient Intake Forms – This includes the intake form (page 1) which requires the date and 3 signature.
Here’s a short explanation about what you are signing:
Medical Release of Information – gives us permission to release the required medical information to process the claim
Assignment of Benefits – assigns us as someone to be paid by your insurance company for your treatment
Consent for treatment – authorizes us to treat you
This page also includes our Notice of Cancellation Policy. Please read this section carefully.
Lastly you’ll be signing the Acknowledgement of Receipt of Notice of Privacy Practices. This simply means that you acknowledge that you got a copy of our HIPAA Notice of Privacy Practices (page 3).
Be sure to read this page and keep it for your records.
For Automobile Accidents
If you were injured in a car accident there are 2 other forms you’ll need to complete.
Lien Form – in the event that your treatment will be paid for through a settlement this form (called a medical lien) establishes our office as one of the parties to be paid for services provided. If you have questions about this form please feel free to ask. If you have retained an attorney you can also talk with them about this standard form.
Accident Questionnaire – this form contains required information about your auto accident including the claim number (you should have received this from your automobile insurance adjuster when you reported the accident), information about your policy, and (as indicated) information about the liable party’s insurance.
Please feel free to call us with any questions about these forms and their content.
Oops… I Forgot Them!
Don’t worry if you forget to bring these forms with you. You can simply fill them out when you get to your appointment.
We look forward to meeting you soon!