Patients

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Patient Forms

At Physical Rehabilitation Group, our therapists focus on three areas to guarantee that you will have a complete rehabilitation experience: minimizing pain, providing hands-on therapy, and addressing mobility in a safe and relaxed environment.

• Consent for Care and Medical Treatment (.pdf)
• Notice of Privacy Practices (.pdf)
• Request for Access to Patient's Health Information / Authorization for Release of Medical Information (.pdf)
• Patient Information (.pdf)
• Financial Agreement (.pdf)
• Patient Referral Form (.pdf)
• Patient Medical Records Request (.pdf)

Insurance

PLEASE NOTE: It is the patient's responsibility to make sure their insurance policy is in network with the center they are interested in attending. If you do not see your plan listed here, please call the number listed on the back of your insurance card to see if there has been a coverage change.