Physical Therapy Paperwork for all PPO’s, Medicare, Workers’ Compensation and Motor Vehicle Accidents:
 

Please click on the links below and print them out before you come to your first visit with us. 

1.     New Patient Intake Form

2.     Patient Health Questionnaire

3.     Confidential Communication Form

4.     Notice of Responsibility Form

 
*  Please note, for Workers’ Comp and Motor Vehicle Accident patients, we must have a claim number and the adjustors name and phone for billing purposes.

Blue Shield of California Patients Only:

Please click on the following Links and print them out before you come to your first visit with us.

1. New Patient Intake Form
2. Confidential Communication Form
3. Notice of Responsibility Form
4. The Blue Shield form that pertains to your condition (i.e. neck, back, arm, and lower extremity)

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