INTAKE FORM FOR NEW PATIENTS
Please print and complete intake forms (below in your preferred language) before arriving for your Physical or Occupational Therapy initial evaluation. If you do not have printing capability, please email completed forms to rjphysicalreception@yahoo.com.
WHAT WILL I NEED FOR MY FIRST APPOINTMENT?
Frequently Asked Questions
DO I NEED TO FILL OUT THE INTAKE FORMS AHEAD OF TIME?
No. We can also provide you with these forms in-office.
However, if you would like to complete these forms prior to your initial evaluation, please download the paperwork above in your preferred language to your device. You may print and complete at home, and then bring these papers in to the office on the day of your first appointment.
Please bring in:
-
your referral from your doctor or your authorization from your insurance's medical group
-
a valid form of ID
-
your current insurance card.
โ
If we are missing one of these three during your initial visit, you may not be able to be seen for evaluation. If you are being seen for therapy through Workers' Comp, you are not required to bring your insurance card.
CAN I FILL OUT THE FORM ONLINE?
No, however, if you are able to scan your completed intake forms, you may email to rjphysicalreception@yahoo.com ahead of time.