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NOTICE OF PRIVACY PRACTICES ACKNOWLEDGEMENT PERFORMANCE PHYSICAL THERAPY 12525 EAST MISSION #104 SPOKANE, WA 99216 I understand that, under the Health Insurance Portability & Accountability Act of
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How to fill out a performance physical therapy form:

01
Start by carefully reading through the form to familiarize yourself with its contents and sections.
02
Begin by providing your personal information, such as your name, date of birth, address, and contact details.
03
If required, provide your medical insurance information, including your policy number and any relevant details.
04
Proceed to the section where you will be asked about your medical history. Fill in details about any previous injuries, surgeries, or conditions that may be relevant for the physical therapist to know.
05
The next section may ask you to list any medications you are currently taking. Ensure you include the name, dosage, and frequency of each medication.
06
You may be asked to fill out a brief questionnaire about your current level of physical activity and any specific goals you have for physical therapy.
07
If applicable, provide details about your current referring physician or healthcare provider who has recommended physical therapy.
08
In some cases, the form may include a section where you can write down any questions or concerns you have for the physical therapist. Feel free to utilize this space if needed.
09
Finally, review the completed form for accuracy and completeness before submitting it to the physical therapy clinic.

Who needs performance physical therapy?

01
Individuals recovering from an injury or surgery: Performance physical therapy can help individuals regain strength, mobility, and function after an injury or surgical procedure.
02
Athletes looking to enhance performance: Performance physical therapy can assist athletes in improving their strength, endurance, flexibility, and overall performance.
03
People with chronic conditions or pain: Performance physical therapy can provide relief and management strategies for individuals living with chronic pain or conditions such as arthritis, fibromyalgia, or back pain.
04
Individuals with movement or balance issues: Performance physical therapy can address gait abnormalities, improve balance, and enhance coordination for individuals with movement disorders or balance impairments.
05
Older adults seeking to maintain independence: Performance physical therapy can help older adults maintain their functional independence and prevent falls through exercises targeting strength, balance, and flexibility.
06
Individuals with work-related injuries: Performance physical therapy can aid in the rehabilitation process for individuals who sustain injuries or musculoskeletal problems in the workplace.
07
Pre and post-operative patients: Performance physical therapy can be beneficial before and after surgical procedures, helping individuals prepare for surgery and accelerate their recovery post-surgery.
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Performance Physical Therapy is a type of rehabilitation that helps to restore physical function and mobility.
Performance Physical Therapy is typically recommended for individuals who are recovering from injuries, surgeries, or chronic pain conditions.
To fill out a Performance Physical Therapy form, you will need to provide information about your medical history, current symptoms, and goals for therapy.
The purpose of Performance Physical Therapy is to improve physical strength, flexibility, and overall function.
Information reported on Performance Physical Therapy forms may include patient demographics, insurance information, assessment findings, treatment plans, and progress notes.
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