Get Physical Order Form

This guide is designed to assist users in completing the Physical Order Form online. By following these steps, individuals will be able to fill out the necessary details accurately and efficiently.

Follow the steps to successfully complete the Physical Order Form.

1. Click the ‘Get Form’ button to access the Physical Order Form and open it for completing online.
2. Begin by entering the patient’s name in the designated text field. This is essential for identifying the individual receiving therapy services.
3. Next, input the patient's medical record number (MRN) for proper tracking and documentation.
4. Fill in the diagnosis section with relevant details pertaining to the patient’s condition.
5. Document any surgical procedures the patient has undergone, if applicable, to give context to their treatment.
6. Include precautions necessary for the patient's safety, ensuring that all potential risks are accounted for.
7. List any known allergies to inform healthcare professionals during treatment.
8. Specify the frequency of the therapy sessions required for the patient based on their needs.
9. Select the type of therapy referral from the available options, including Physical Therapy, Occupational Therapy, or Hand Rehab Referral.
10. Provide treatment recommendations by checking appropriate boxes for services such as evaluation, spine rehabilitation, or aquatic therapy.
11. Fill in the physician's signature, printed name, and contact information to validate the order.
12. Input insurance information as required, ensuring that all necessary details for billing are correctly entered.
13. Before finalizing, review all entered information for accuracy.
14. Once complete, choose to save your changes, download the form, print it, or share it as needed.

Start completing the Physical Order Form online today to ensure timely and efficient processing.