Get Excel Physical Therapy Patient Data Sheet 2021-2025

Completing the Excel Physical Therapy Patient Data Sheet is an important step in receiving care. This guide will walk you through the key sections of the form to ensure that you provide all necessary information accurately and efficiently.

Follow the steps to fill out the form successfully.

1. Click the ‘Get Form’ button to obtain the Excel Physical Therapy Patient Data Sheet and open it in the editor.
2. Begin by entering your personal information in the designated fields. This includes your first name, middle initial, last name, date of birth, gender, and age. Ensure that the details are correct.
3. Fill in your physical and mailing addresses along with your phone numbers. Specify the preferred contact number and indicate the best times to be reached.
4. Respond to the questions regarding text message and email preferences for appointment reminders and marketing materials. Your responses will determine the communication methods available to you.
5. Provide details about your referring physician, the date of your injury, and the area of injury. Indicate if the injury was due to an auto or work accident and the state where the accident occurred.
6. Answer questions on previous home health services and other therapy services received in the last 60 days to provide your therapist with relevant background.
7. Select your marital status and student status as applicable. This information can be useful for demographic profiling.
8. In the employment status section, indicate your current employment situation and provide contact information for your employer if applicable.
9. Complete the insurance information section, including the details of your primary and secondary insurance coverage.
10. Answer the 'How did you hear about us?' question by selecting or specifying the source of your information to assist with the clinic's outreach efforts.
11. List emergency and other contacts, providing their names, phone numbers, and their relationship to you.
12. Authorize any individuals you wish to grant access to your medical and billing records by entering their names and relationships.
13. Read and initial all consent sections regarding treatment, liability, and financial policy. Ensure you understand the implications of these consents.
14. Finally, review all entered information for accuracy, and upon completion, save changes, download, print, or share the form as necessary.

Take the next step in your therapy journey by completing the Excel Physical Therapy Patient Data Sheet online today.