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PHYSIOTHERAPY: INTAKE RELEASE FORM CLIENT NAME: COLLEGIATE SPORTS MEDICINE INC. DATE OF BIRTH: Phone: Label each with work, cell, home, etc & check which number to use for apt reminders Email Address:
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How to fill out physiotherapy intake release form

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How to fill out a physiotherapy intake release form:

01
Start by reading the form carefully and ensure that you understand all the information requested.
02
Begin by providing your personal details, including your name, date of birth, address, and contact information.
03
Next, provide information about your medical history, including any past surgeries, injuries, or medical conditions that may be relevant to your physiotherapy treatment.
04
Include information about any medications you are currently taking, including dosage and frequency.
05
Indicate any allergies or sensitivities you have, as well as any food or drug allergies.
06
Answer all questions regarding your current symptoms or concerns that you are seeking physiotherapy treatment for.
07
Finally, review the form once again to ensure that you have completed all the necessary sections and provided accurate information.
08
Remember to sign and date the form at the bottom to acknowledge that all the information provided is true and accurate.

Who needs a physiotherapy intake release form?

01
Anyone seeking physiotherapy treatment for a specific condition or injury may be required to fill out a physiotherapy intake release form.
02
This form is necessary for the physiotherapist to have a complete understanding of your medical history, current symptoms, and any potential risks or contraindications for treatment.
03
It helps the physiotherapist assess your condition accurately, develop an appropriate treatment plan, and ensure your safety during the therapy sessions.
04
The form also serves as a legal document that outlines the rights and responsibilities of both the patient and the physiotherapist.
05
Therefore, it is important for individuals who are planning to undergo physiotherapy to fill out this form in order to receive the most effective and safe treatment possible.
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