Get Physical Therapy Intake Form

Completing the Physical Therapy Intake Form online is an essential step in starting your treatment journey. This guide will walk you through each section of the form, ensuring that you provide all necessary information accurately and efficiently.

Follow the steps to complete the form with ease.

1. Click 'Get Form' button to access the Physical Therapy Intake Form online.
2. Begin by filling in your patient information, including your name, contact numbers, address, date of birth, and social security number. Make sure to provide accurate details as this information is crucial for your treatment.
3. Indicate your gender, height, weight, occupation, marital status, and employment details in the relevant fields. If you are a minor, provide the name of your parent or guardian.
4. Complete the section related to your accident information. Please include the date and time of the accident, town, and street where it occurred. Elaborate on how the accident happened and any symptoms you experienced immediately after.
5. Fill out your auto insurance information, providing details such as the insurance company, adjustor's name, and policy holder's name, along with the claim number.
6. Proceed to the health history section, where you will circle 'Yes' or 'No' for various health conditions. This information will help the physical therapy team understand your overall health status.
7. In the current health conditions section, enter your major complaint, when symptoms started, and other relevant details. Be prepared to discuss any medications you are currently taking.
8. Review and complete the acknowledgments regarding office policies, ensuring you understand the terms before signing. This section is essential for establishing your agreement to the treatment process.
9. Finally, after filling out all necessary fields, save your changes. You will have the option to download, print, or share the completed form as needed to keep a record.

Start filling out your Physical Therapy Intake Form online today to ensure a smooth intake process.