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ANDREW A. AUCTION, PT, PhD, DPT, FAPTALICENSURE:Physical Therapist, Massachusetts Physical Therapist, Virginia Physical Therapist, District of ColumbiaEDUCATION:DPT, September 2003 MPH Institute of
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Start by obtaining a copy of the geriatric physical therapy form.
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Read the instructions and familiarize yourself with the sections of the form.
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Begin by filling out the personal information section, including name, date of birth, address, and contact information.
04
Proceed to the medical history section and provide accurate details about any past medical conditions, surgeries, or hospitalizations.
05
Fill out the current medication section, listing any prescribed medications along with dosage and frequency.
06
If applicable, complete the section on allergies, indicating any known allergies or adverse reactions to medications.
07
Move on to the section on physical limitations or disabilities, describing any mobility issues, chronic pain, or motor impairments.
08
Provide information about any assistive devices or mobility aids currently being used.
09
Include details about any recent accidents or injuries that may impact the physical therapy treatment.
10
Complete the form by signing and dating it, indicating your consent for the geriatric physical therapy assessment.
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Optionally, attach any relevant medical reports or imaging results that may support the assessment process.
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Double-check the form for completeness and accuracy before submitting it to the appropriate healthcare provider or facility.

Who needs geriatric physical formrapy by?

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Geriatric physical therapy forms are typically required for elderly individuals who require specialized physical therapy services.
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This may include older people who have experienced a decline in physical function, who have had recent surgeries or injuries, or who are managing chronic conditions.
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Individuals with impaired mobility, balance issues, muscle weakness, or pain may also benefit from geriatric physical therapy.
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These forms help healthcare providers assess the individual's physical health, design personalized treatment plans, and monitor progress over time.
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It is recommended to consult with a healthcare professional or geriatric physical therapist to determine if this form is necessary for your specific needs.

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