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About Us

Getting Started

Paperwork Required for First Visit

New and Returning Patients - Please print and complete forms below:

Step 1       New & Returning Patients (choose 1 type of Patient forms below that is applicable to you)

Standard Patient Forms                                                         Medicare Patient Forms

Women's Health Forms (Pelvic Floor only)                        Medicare Women's Health Forms (Pelvic Floor Only)

   *Please bring a detailed list of MEDICATIONS you are currently taking*

 Step 2

Choose what best applies to you

Neck Pain Scale

Low Back Pain Scale

Shoulder - Arm Pain Scale

Wrist - Hand Pain Scale

Hip Pain Scale

Knee Pain Scale

Foot and Ankle Pain Scale

Vertigo - Dizziness Scale

Dry Needling Consent Form 

Patient Specific Functional Scale      (Women's Health Only)

Step 3

Patient Attestation Form (if applicable)

Direct Access - Did you know that per the state of Virginia direct access guidelines, a Physical Therapist may treat patients for up to 4 weeks without MD referral. However, most, if not all, health insurance companies require a physician referral from the first date of service for reimbursement purposes.

For this reason, it is recommended that every patient obtain a physician prescription and/or referral as required (referrals are required for some Aetna and all MAMSI covered patients, e.g.) and bring this with them to the first PT appointment. Please also bring a picture ID and your insurance card for verification purposes.

If you have obtained paperwork from our web-site, please bring the completed forms with you as well. If not, we ask that you arrive 15-20 minutes early to complete the admission paperwork process.

Upon your first visit, please bring all of the following:

  • New patient information and Assessment Forms
  • Physician Referral and /or Prescription or a Completed Self Referral Form
  • Insurance card & Identification
  • Comfortable clothing and sneakers

General Information:

HIPAA and Patient Bill of Rights

What is the difference between a Physician Referral and a Prescription?

Some insurances require a physician's referral for coverage of Physical Therapy. Insurances that require a "Referral" are the responsibility of the patient or if a minor that of the parent or legal guardian. If you have a HMO insurance card and a primary care physician you most likely will need a referral. Please call your insurance company and/or contact your primary care physician's office if you have any questions.

Medical Records Retention Information