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AQUATIC PHYSICAL THERAPY REFERRAL Active Physical Therapy & Associates 101 S. Tracy Blvd. Tracy Ca 95376 Tel: (209) 8308855; Fax: (209) 8308837 Kay Miller PT & Jim Miller PT, DC Name of Referring

How to fill out aquatic physical formrapy referral

How to fill out aquatic physical formrapy referral

1. To fill out an aquatic physical therapy referral form, follow these steps:
2. Begin by filling out the patient's personal information, including their full name, date of birth, and contact details.
3. Provide the patient's primary care physician's name and contact information.
4. Indicate the reason for referral, specifying the specific condition or injury requiring aquatic physical therapy.
5. Include any relevant medical history and past treatments related to the patient's condition.
6. Include the patient's insurance information, including policy number and coverage details.
7. If necessary, provide specific instructions or limitations for the aquatic physical therapy referral.
8. Have the referring healthcare professional sign and date the form before submitting it.
9. Ensure that all the required fields are completed before submitting the referral form.
10. By following these steps, you can successfully fill out an aquatic physical therapy referral form.

Who needs aquatic physical formrapy referral?

1. Aquatic physical therapy referral is generally needed by individuals who require specialized rehabilitation or treatment for specific conditions or injuries. This form referral may be necessary for patients who have experienced orthopedic injuries, musculoskeletal conditions, post-operative recovery, pain management, arthritis, neurological disorders, sports-related injuries, and various other physical conditions that can be improved or managed through aquatic therapy. It is important to consult with a healthcare professional to determine if aquatic physical therapy is appropriate and if a referral is necessary.

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