Physical Therapy Intake Form

Patients can fill in their medical history, their background with injuries and their current pain with this printable physical therapy intake form.

 WHAT TO EXPECT ON YOUR FIRST VISIT

Please arrive 10-15 minutes before your scheduled appointment to complete intake forms. Please bring your insurance card and referral order from your doctor, if applicable. You may choose to complete the Patient Intake Form prior to your appointment by downloading the two forms above.

You can expect:

  • To provide your therapist with your current condition and your personal therapy goals.
  • A physical exam assessment.
  • To create a treatment plan personalized to your needs and goals.

 HOW TO SCHEDULE AN APPOINTMENT

Call us at your convenience!

Please be ready to provide us with:

  • Your Personal Information
  • Your Injury
  • Your Insurance Plan or Self Pay Information
  • Your Referral ( if you have one)