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HO PHYSICAL THERAPY 9675 BRIGHTON WAY SUITE 250 BEVERLY HILLS, CA 90210 TEL: (310) 2785337 FAX: (310) 2786204PLEASE PRINT PATIENTS NAME___ SS#___ AGE___ BIRTHDATE(DOB)___ MARITAL STATUS___ DRIVERS
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01
Begin by gathering all necessary information such as personal details, medical history, and insurance information.
02
Complete the patient information section with accurate and up-to-date details.
03
Provide details of the reason for seeking physical therapy services and any relevant medical conditions.
04
Fill out the section on current medications and allergies, if applicable.
05
Sign and date the form to certify the accuracy of the information provided.

Who needs ho physical formrapy?

01
Individuals who have been prescribed physical therapy by a healthcare provider.
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Those who have recently experienced an injury or surgery and require rehabilitation.
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Athletes looking to improve their performance or recover from sports-related injuries.
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Individuals with chronic pain or mobility issues seeking professional assistance.
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Ho physical formrapy is a medical form that documents a person's medical history and physical examination.
Patients or individuals seeking medical treatment are typically required to fill out ho physical formrapy.
Ho physical formrapy can be filled out by providing accurate information about medical history, current health conditions, and any medications being taken.
The purpose of ho physical formrapy is to help healthcare providers assess a patient's health status and provide appropriate medical treatment.
Information such as medical history, current health conditions, medications, allergies, and any recent surgeries or hospitalizations must be reported on ho physical formrapy.
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