Patients
Patient Resources
Getting Ready For Your First Visit
Patients should bring physical therapy referrals (provided to you by the doctor, nurse practitioner, or physician assistant), an ID and a form of payment.
Print out any required patient forms below, fill them out, and bring them with you during the first visit. Arrive 15 minutes early to complete additional paperwork to maximize your time in evaluation. Wear loose fitting clothing for easy access to injured area and for ease of treatment. Wear sneakers that are supportive.
Insurance And Payment Information
We accept the following plans:
- Aetna (Medicare Advantage PPO; Benefit Plan)
- Cigna (Benefit Plan)
- Wellcare (Medicare Advantage HMO; Benefit Plan)
- Blue Cross Blue Shield HMO and PPO plans for TX
- United Healthcare
- Traditional Medicare
- We are currently able to see Tricare with out of network benefits while we finish getting credentialed.
- Traditional Medicaid
- Humana
- Champ VA
- AARP
- Superior HealthPlan
- Workers Comp
While cash is an acceptable form of payment if you have a different insurance plan, we also accept checks, all major credit and debit cards, as well as FSA and HSA accounts.
Forms
- Patient Intake Form
- Consent and Cancellation Forms
- Physical Therapy Medical Screening Questionnaire
- Fear-Avoidance Beliefs Questionnaire
- Foot Function Index
- Lower Extremity Functional Scale (LEFS)
- Neck Disability Index Questionnaire
- Modified Oswestry Low Back Pain Disability Questionnaire
- QuickDASH Outcome Measure
- Shoulder Pain and Disability Index (SPADI)
- Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)
- Dry Needling Consent Form
Submit Completed Forms
After completing any required forms, please email them to:
info@completeperformancept.com
If you have scheduled your appointment through Jane, many intake forms, insurance information, and required consents can be completed securely through your Jane patient intake.