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WELLSPRING PHYSICAL THERAPY37 West Main Street Midway, UT, 84049 Phones: 4356570123 Last)___ Fax: 4356570330NEW PATIENT INFORMATION (Please Print) Name (First, Middle, Krista J. Clark, PT, ADOPT Today\'s
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01
Obtain a copy of the wellspring physical therapy form from the clinic or healthcare provider.
02
Fill out personal information including name, date of birth, address, and contact information.
03
Provide details about your medical history, including any past injuries, surgeries, or chronic conditions.
04
Describe the reason for seeking physical therapy and any specific areas of concern or pain.
05
Answer any additional questions or sections on the form as requested.
06
Review the completed form for accuracy and make sure all areas are filled out before submitting to the healthcare provider.

Who needs wellspring physical formrapy and?

01
Individuals who have been referred to physical therapy by their healthcare provider.
02
Patients recovering from injuries or surgeries that require physical rehabilitation.
03
People with chronic conditions or pain that could benefit from physical therapy.
04
Athletes looking to improve performance or prevent injuries through physical therapy.
05
Anyone seeking to improve mobility, strength, or function through exercise-based therapy.
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Wellspring physical formrapy is a comprehensive evaluation of a person's physical health and capabilities.
Individuals who have been prescribed physical therapy or those who want to assess their physical health and capabilities are required to file Wellspring physical formrapy.
To fill out Wellspring physical formrapy, one must provide accurate information about their medical history, current health status, and any physical limitations or conditions.
The purpose of Wellspring physical formrapy is to create a personalized plan for physical therapy and to monitor progress throughout the treatment.
Information such as medical history, current health status, physical limitations, and any pre-existing conditions must be reported on Wellspring physical formrapy.
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