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MR #: Patient Name:Page: 1/4LIFE STRIDES PHYSICAL THERAPY PATIENT DATA SHEET First:MI:Date of Birth:Last: Gender: Mileage:Physical Address:FemaleMailing Address:Phone Numbers:OK To Call Best Time
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How to fill out life strides physical formrapy

01
To fill out the Life Strides physical therapy form, follow these steps:
02
Start by providing your full name, date of birth, and contact information.
03
Next, fill in your current address and emergency contact details.
04
Specify your primary healthcare provider and any other therapists you are currently seeing.
05
Indicate your insurance information, including the policy number and group number.
06
Complete the medical history section, including any past surgeries, medical conditions, or injuries.
07
Describe your current symptoms or concerns that require physical therapy.
08
Provide a list of any medications or supplements you are currently taking.
09
Mention any allergies or adverse reactions you have had to medications in the past.
10
Sign and date the form to certify that the information provided is accurate and complete.

Who needs life strides physical formrapy?

01
Life Strides physical therapy is beneficial for individuals who:
02
- Are recovering from surgery or injury and require rehabilitation.
03
- Have chronic pain or musculoskeletal conditions that affect their mobility.
04
- Need assistance with improving balance and coordination.
05
- Have neurological conditions such as stroke, Parkinson's disease, or multiple sclerosis.
06
- Are athletes looking to enhance performance or prevent injuries.
07
- Seek relief from back, neck, or joint pain.
08
- Require postural re-education or ergonomic advice.
09
- Want to improve their overall physical fitness and well-being.
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Life Strides Physical Therapy is a form of treatment that focuses on improving physical movement and function through exercises and manual therapy techniques.
Individuals who have received physical therapy services from Life Strides Physical Therapy are required to file the form.
To fill out the form, individuals must provide details of the physical therapy services received, including dates, duration, and specific exercises performed.
The purpose of the form is to document the physical therapy services received and track progress towards physical improvement.
Information such as dates of therapy sessions, exercises performed, and progress made towards physical goals must be reported on the form.
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