Patient Forms
The following forms complete the initial paperwork prior to initiating a physical therapy evaluation and treatment. Please feel free to print these forms and arrive with them completed. We continue to request that you arrive 15 minutes early to your appointment for administrative purposes and the completion of your registration.
- Patient Information
- Medical Questionnaire
- Pain Scale
- Privacy (HIPPA) Statement (informational only, no need to print)
- HIPPA Acknowledgement
- Cancellation Policy
Participating Insurances
The following is a list of insurance companies with which we participate. Please note that insurance credentialing is an ongoing process. If your insurance company is not listed here, please feel free to contact our office so that we may attempt to verify your benefits to either: attempt to obtain in-network status or obtain out-of-network benefits.
- Aetna
- Amerihealth
- Automobile Insurance
- Capital Blue Cross
- Cigna
- Dart Medical
- Educators Health Partners – EHP Significa
- Freedom Blue and Freedom Blue PFFS
- Health America/Assurance
- Highmark Blue Shield Plans
- Humana Gold
- Humana Choice Care Network
- Keystone Central
- Medicare
- MultiPlan
- PHC
- PHCS
- Tricare/Champus
- United Health Care
- Workmen's compensations
