Get the free NEW PT FORM FOR PATIENTSdocx rev 04212009docx

PATIENTS NAME DATE OF BIRTH: EMAIL ADDRESS: CELL PHONE #: MAILING ADDRESS: HOME PHONE #: CITY: STATE: / / AGE: ZIP CODE: PATIENTS EMPLOYER: OCCUPATION: EMPLOYERS ADDRESS: EMP. PHONE #: SOCIAL SECURITY

How to fill out new pt form for

How to fill out new PT form:

1. Ensure that all personal information is accurately filled out, including your name, address, contact information, and any other relevant details requested on the form.
2. Provide any medical history and relevant information, such as current medications, allergies, previous injuries or surgeries, and any other pertinent health-related details that may be required.
3. Be sure to answer all questions on the form truthfully and thoroughly, as this information is crucial for the healthcare professionals to provide proper care and treatment.
4. If there are any sections on the form that you are unsure about or do not have the necessary information for, it is important to ask for assistance from a healthcare professional or the staff responsible for administering the forms.
5. Once you have filled out all the required sections, review the form for any errors or omissions before submitting it. Double-check your responses and make any necessary corrections.
6. If you are unsure about any specific requirements or instructions on the form, don't hesitate to ask for clarification to ensure that you accurately complete the form.

Who needs new PT form for:

1. Individuals seeking physical therapy treatment for a specific condition, injury, or rehabilitation.
2. Patients who have not previously received physical therapy but require the services for their healthcare needs.
3. Individuals who have completed their previous sessions of physical therapy and are returning for further treatment or follow-up care.
4. Patients who have been referred to a physical therapist by their primary care physician or other healthcare provider.
5. Athletes, whether professional or amateur, who require physical therapy services for injury prevention, performance improvement, or rehabilitation purposes.
6. Individuals involved in accidents, such as car accidents or workplace injuries, who need physical therapy as part of their recovery process.
7. Anyone experiencing musculoskeletal pain, mobility issues, balance problems, or other conditions that may benefit from physical therapy interventions.

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