Office Forms
(Please bring all completed forms on your first visit)
All patients are required to fill out the two forms listed below.
If your health insurance is:
- Oxford(United Health Care)
- United Health Care
- The Empire Plan(NYSHIP)
Please fill out the following form below.
If your health insurance is:
- Blue Cross Blue Shield Senior / Medi Blue Plan
Please fill out the following form below.
Required section for all patients
If your injury, condition, or disorder involves your neck, back, arm, and or leg please fill out the following form(s) that best describes the body part(s) that you will be receiving physical therapy for below.
Neck Back
Arm Leg
(Please bring all completed forms on your first visit)
TO ALL NO FAULT PATIENTS :
PLEASE FILL OUT THE REQUIRED NEW YORK STATE NO FAULT APPLICATION AND BRING IT IN ON YOUR FIRST VISIT.
