PATIENTS

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 the patient forms below, fill them out, and bring them with you during the first visit, or submit them below via our secure form.
• 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

1. Aetna (Medicare Advantage PPO; Benefit Plan)
2. Cigna (Benefit Plan)
3. Wellcare (Medicare Advantage HMO; Benefit Plan)
4. Blue Cross Blue Shield HMO and PPO plans for TX
5. United Healthcare
6. Traditional Medicare
7. We are currently able to see Tricare with out of network benefits while we finish getting credentialed.

• We are working towards credentialing to accept most major health insurance plans, including Humana and Medicaid

• 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

General Statement of Physical Therapy and Procedures patient intake form |  consent and cancellation forms

Physical Therapy Medical Screening Questionnaire Medical Screening Form

FABQ Questionnaire Fear avoidance beliefs questionnaire2

Foot Function Index foot function index

Lower Extremity Functional Scale (LEFS) Lower Extremity Functional Scale (LEFS)

Neck Disability Index Questionnaire Neck_Disability_Index

Modified Oswestry Low Back Pain Disability Questionnaire Oswestry_Disability_Index-1

Quickdash Outcome Measure The QuickDASH Outcome Measure Questionnaire

Shoulder Pain and Disability Index Shoulder Pain and Disability Index (SPADI)

The Western Ontario and McMaster Universities Osteoarthritis Index WOMAC

Dry Needling Consent Form Dry Needling Consent