Get the free KHG Physiotherapy Intake Form - Kensington Health Group

Physiotherapy Questionnaire Name: Date: 1. Please describe your complaint: a. Description: b. Frequency Sharp Pain Constant (76100%) Dull Pain Frequent (5175%) Ache Occasional (2650%) Weak Intermittent

How to fill out khg physiotherapy intake form

How to fill out the KHG physiotherapy intake form:

1. Start by carefully reading the instructions provided on the form. This will give you an understanding of what information is required and how to properly fill out the form.
2. Begin by providing your personal information in the designated fields. This typically includes your full name, date of birth, address, contact number, and email address. Make sure to double-check the accuracy of this information before moving on.
3. The next section of the form may ask for details about your medical history. Fill out any relevant information regarding past injuries, surgeries, or medical conditions that are important for the physiotherapist to know. This will help them assess your condition better and tailor the treatment accordingly.
4. You may be asked to describe your current symptoms or reasons for seeking physiotherapy. Be specific and provide as much detail as possible. This will assist the physiotherapist in understanding your needs and formulating an appropriate treatment plan.
5. In some cases, you may be required to indicate any medications you are currently taking. Provide the names of the medications, dosage, and the reason for taking them. This information is crucial as certain medications can impact the type of treatment or exercises prescribed.
6. If you have any allergies, make sure to mention them on the intake form. This includes both medication allergies and allergies to any substances used during physiotherapy treatments.
7. The form may also ask about your daily activities, exercise habits, and lifestyle choices. Be honest and provide accurate information as this will help the physiotherapist gauge your overall physical fitness level.
8. Depending on the form, you may be required to answer questions regarding your insurance coverage or payment options. Provide the necessary details as requested to ensure a smooth billing process.

Who needs a KHG physiotherapy intake form?

1. Individuals seeking physiotherapy treatment at KHG clinic or facility.
2. Patients who have scheduled an appointment with a physiotherapist at KHG for an initial assessment or ongoing treatment.
3. New patients who want to access physiotherapy services at KHG and need to provide their medical history and other relevant information.

Note: The specific requirements for filling out the KHG physiotherapy intake form may vary, so it is essential to carefully review the form and follow any additional instructions or sections provided.

For pdfFiller’s FAQs

What is khg physiotherapy intake form?

The khg physiotherapy intake form is a document used to collect information about a patient's medical history, current condition, and treatment goals prior to starting physiotherapy treatment.

Who is required to file khg physiotherapy intake form?

Any individual who is seeking physiotherapy treatment from khg physiotherapy clinic is required to fill out and submit the intake form.

How to fill out khg physiotherapy intake form?

The khg physiotherapy intake form can be filled out either online through their website or in person at the clinic. Patients are required to provide accurate and detailed information about their medical history and current symptoms.

What is the purpose of khg physiotherapy intake form?

The purpose of the khg physiotherapy intake form is to gather essential information about the patient's health status, previous treatments, and goals for physiotherapy treatment. This information helps the physiotherapist in assessing the individual's needs and developing a customized treatment plan.

What information must be reported on khg physiotherapy intake form?

The khg physiotherapy intake form typically requires information such as personal details, medical history, current symptoms, previous treatments, medications, allergies, and goals for the physiotherapy treatment.

When is the deadline to file khg physiotherapy intake form in 2023?

The deadline to file khg physiotherapy intake form in 2023 is typically within a week prior to the first scheduled physiotherapy appointment. Patients are advised to check with the clinic for the exact deadline.

What is the penalty for the late filing of khg physiotherapy intake form?

The penalty for the late filing of khg physiotherapy intake form may vary depending on the clinic's policy. It is recommended to submit the form on time to avoid any delays in starting the physiotherapy treatment.

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