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Preparing for Your Physical Therapy and Wellness Care

To make your first visit go smoother, please print and complete the Medical History and Patient Intake forms located below. Please see the Your Appointment web page for additional information on your session with us.

Wellness Program Waiver

Don't have a physician referral/prescription? Print out our convenient Referral/Prescription Form and ask your physician to fill it out today!

Referral/Prescription Form

All Medicare patients are required to fill in the two Medicare-related forms below, in addition to the Patient Intake and Medical History forms above.

Medicare Intake Form

Advance Beneficiary Notice of Non-coverage (ABN), Form CMS-R-131


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