Patient Information / Forms
New Patient Information
Please be sure to bring the following items with you to your first appointment:
- New patient registration forms - Completed (see below). If you are unable to download and complete the necessary forms prior to your appointment, then we ask you to arrive to your appointment 15 minutes early in order to fill them out.
- Prescription or referral - For physical therapy from your physician if you were seen by a physician.
- Under direct access in New York State, you no longer need a prescription from your physician to be seen by a licensed physical therapist for the first 30 days (10 visits). However, your insurance carrier may require a prescription for coverage of medical claims. Please contact your insurance company regarding your policy prior to your first appointment to verify coverage without a physician referral.
- All insurance information - Necessary to process your claims.
- Co-payment - We accept check, credit card (Visa/MC/Discover/AE), or cash.
Before coming to your first appointment, please print out and complete:
- NY patients only - Patient Information and Medical History form
- Massachusetts patients only - Patient Information and Medical History form
Also, please print out and complete the following as indicated.
If you are experiencing:
- Back pain or discomfort, please complete this form.
- Neck pain or discomfort, please complete this form.
- Lower extremity pain or discomfort, please complete this form.
- Upper extremity pain or discomfort, please complete this form.
You will need to install Adobe Acrobat Reader in order to open these files. Click to download a free version.
What To Expect
Your initial visit will be about an hour in duration and will consist of the following:
- An interview and discussion regarding your current injury/condition.
- A review of your past/current medical history.
- An orthopedic physical examination including visual inspection of injured area, manual therapy/palpation, and movement testing.
- Instruction on a self care program including a written home exercise program, injury education/management, and postural/ergonomic corrections as applicable to your condition.
- An initial recommended treatment plan with an overview of goals and progression of your rehabilitation.
- Time allotted for questions and answers regarding all relevant material.
We are proud participating providers of most insurance carriers including the following companies. Not all providers are listed so if you do not see your carrier listed, please call our office to ask if we participate or call your carrier directly for information regarding participating providers.
If you are unsure of your insurance policy's coverage for outpatient physical therapy services, please contact them prior to arranging your initial visit. As a courtesy, on your first visit we will verify coverage and inform you of all details pertaining to your coverage, however it is your responsibility to be aware of your healthcare benefits. Please refer to our Practice Policies below for additional information.
CDPHP 800-777-2273 www.cdphp.com
Empire Blue Cross 800-992-2583 www.empireblue.com
New York State Empire Plan 877-7NYSHIP
Blue Shield of Northeastern NY 518- 220-5700 www.bsneny.com
Fidelis Care 888-33-3547 www.fideliscare.org
Please review the following practice policies for your informed consent. If you have any questions regarding any information provided, please address these issues with our reimbursement specialists upon your initial visit or you may call our office directly to discuss your concerns.