PATIENT INFO/FORMS

At PHYSIOCARE, we want to maximize your time with us. Prior to your first visit, please print and fill out the new patient forms below. Please bring these with you to your first visit along with your insurance information and driver’s license or state issued ID.

Patient Information

Please be sure to bring the following items with you to your first appointment:

  1. ​​​​​Patient registration forms – Completed (see below). If you are unable to download and complete the necessary forms prior to your appointment, then we ask you to arrive to your appointment 15 minutes early in order to fill them out.
  2. ​​​​​Prescription or referral – For physical therapy from your physician if you were seen by a physician.

    Under direct access in Florida, you no longer need a prescription from your physician to be seen by a licensed physical therapist for the first 30 days. However, your insurance carrier may require a prescription for coverage of medical claims. Please contact your insurance company regarding your policy prior to your first appointment to verify coverage without a physician referral.

  3. All insurance information – Necessary to process your claims.​​​​​
  4. Driver’s license or state issued ID
  5. Co-payment – We accept check, credit card (Visa/MC/Discover/AE), or cash.

 


 

Before coming to your first appointment, please print out and complete:

Also, please print out and complete the following as indicated.

If you are experiencing:

You will need to install Adobe Acrobat Reader in order to open these files. Click to download a free version.

 

 

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