Get the free PTOT REFERRAL FORM - bgocohecomb

Department of Labor and Industries Claims Section PO Box 44291 Olympia WA 985044291 PT/OT REFERRAL From This form is an optional communication tool For Progressively Increasing Activity/Exercise Increase

How to fill out ptot referral form

How to fill out a ptot referral form:

1. Start by obtaining a ptot referral form from either your physician, insurance company, or healthcare provider.
2. Fill out the patient's personal information, including their full name, date of birth, address, and contact information.
3. Provide details about the patient's medical history, including any pre-existing conditions, medications, or allergies.
4. Indicate the reason for the referral by describing the patient's symptoms or the specific therapy required.
5. Include information about the referring physician or healthcare provider, including their name, address, and contact details.
6. Attach any relevant medical documentation or test reports that support the need for ptot therapy.
7. Review the completed form for accuracy and completeness before submitting it to the appropriate party.

Who needs a ptot referral form:

1. Individuals who have experienced an injury or have a medical condition that requires physical therapy or occupational therapy may need a ptot referral form.
2. Doctors, nurses, or healthcare providers may need to fill out a ptot referral form in order to provide their patients with access to the therapy they need.
3. Insurance companies or healthcare facilities may require patients to obtain a ptot referral form in order to verify the medical necessity of the therapy and ensure proper coverage.

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