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Coverage for Your Medical Needs

Patient Registration Form
Formulario De Registro De Pacientes

Basic demographics and insurance information for all patients.

Notice Of Privacy Practice
Physician Referral Form

Please bring the Physician note or Referral signed by the physician with you on your first visit. It is possible that we may be unable to see you without a referral. You can print this Physician Referral Form and have the physician sign it.

Medicare Financial Limitation
Pain Drawing

Form for Medicare patients.                                                    

Back Pain Index
Dolor De Espalda Índice

If you are having a problem in one of the body regions listed in the column, click on that region, print off, and fill out the form and bring it with you. Please do this within 24 hours prior to your appointment.

Neck Pain Index
Dolor De Cuello Índice

Complete la forma apropiada basada en la localización del problema.

Shoulder, arm and hand
Del brazo, del hombro y de la mano

If you are having a problem in one of the body regions listed in the column, click on that region, print off, and fill out the form and bring it with you. Please do this within 24 hours prior to your appointment.

Lower Extremity Pain Index
Dolor Extremidades Inferiores Índice

Complete la forma apropiada basada en la localización del problema.

Patient Registration

We know you have a choice when it comes to your physical therapy care, and we have a passion to serve
you and meet your physical therapy needs. 
On our end:

  • Provide free-screening appointments

  • Obtain a referral for physical therapy from your doctor if one is needed

  • Complete insurance pre-certifications for you

  • Provide easy access to physical therapy care and convenience of scheduling

  • Ensure quality and quantity of time with our therapists

  • Engage in ongoing communication with physicians and third party payers, or insurance providers, or your insurance company.

We encourage you to click on the “Patient Registration Form” and after completing the registration form,  go to the Health Questionnaire form. Please fill out both forms for your first visit .

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