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Physical Therapy Freesight CA
Therapeutic Solutions Physical Therapy
Physical Therapy Freesight CA
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Therapeutic Solutions Physical Therapy Patient Forms

Patient Forms

For your convenience, you can download the patient forms and complete them prior to your first visit. Then, bring the forms with you when you come in for your appointment. If you choose to fill out the patient form packet at our office, please arrive 10-15 minutes before your appointment to allow enough time to get them completed.

Our forms are PDF files. To download and print the forms, you’ll need the free Adobe Acrobat Reader program.

Private Insurance Physical Therapy Patients

Please download the patient intake forms and the form(s) that pertain to the area we are treating:

If the patient is under the age of 18, please also download the Consent to Treat a Minor form.

Formas en Español

Por favor, descargue la forma o formas que pertenecen a la zona que estamos tratando:

Physical Therapy Without a Dr. Prescription

Medicare Physical Therapy Patients

Please also download:

Oxford and The Empire Plan Patients

Please also download:

Government The Empire Plan Patients

Please also download:

HIP Insurance Patients

Please also download:

Notice of Privacy Practices

All patients, please download:

Fitness and Personal Training Clients

Massage Clients

If you have any questions or need assistance please feel free to contact us at (516) 623-4388. You may also go to our FAQ page and listen to the short clip on what to expect on your 1st visit.

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Visit Us At The Annex Wellness & Fitness Center

Hours of Operation
Mon - Thurs 7:30 AM - 9 PM
Fri 7:30 AM - 4 PM
Sat 8 - 2 PM
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