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Welcome to

New Patient Regsitration
Follow 3 Steps Below

CONVENIENT On Line Forms

On Line
Patient Intake

Returning Patient

On Line

GETTING STARTED IS AS SIMPLE AS 1-2-3

1
​Relax knowing your with the right team and in the right hands.​

2
Download and
​Fill Out Forms
3
Fax or Bring in your Documents 
Pre Evaluation Checklist
New Patient Registration
Health History Form
Medication List
LIST OF CLINICS ADDRESSES
AND FAX NUMBERS
Important Notice:
Preserve Your Access
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Pre Evaluation Checklist

Please fill out the following form to help us understand your physical condition.The following items need to be completed and returned to Onsite Physical Therapy two days prior to your scheduled Initial Evaluation. You can come by the fitness center anytime during normal business hours to fill these out and get your insurance cards copied.

 

Please call the office at (561) 745-5925 with any insurance coverage questions, as we may be out of your network. Thank you! We look forward to working with you!

Physical Therapy Prescription (dated no longer than 30 days prior to Initial Evaluation with the therapist)
Insurance Cards & Photo ID copied: (including front and back of Secondary insurance card)

Thanks for submitting!

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