Paperwork

Please bring the following information and completed forms to your initial evaluation:

1. Up-to-date medical insurance card.
2. Current prescription/referral from your doctor for physical therapy treatment.
3. Picture I.D.
4. Complete General Registration Packet (See "A" Below).
5. Area of Injury Form (See "B" Below).

1. General Registration Forms - all patients please fill out all forms in this section
   • Patient Registration
   • Medical Information
   • Cancellation and No-Show Policy
   • Pilates Waiver of Liability
2. Area of Injury Forms - please fill out the ONE form that pertains to your injured area
   • Neck Injury
   • Upper Extremity Injury (shoulder/elbow/wrist/hand)
   • Back Injury
   • Lower Extremity Injury (hip/knee/ankle)
3. Blue Shield Patients ONLY
   • PT Notification Form (top portion only)
   • Patient Health Questionnaire (entire form)
4. Optional - download a physical therapy prescription to take with you on your doctor's visit

[Printable Version]