Supporting our patients during the COVID-19 response
Patient Forms
Patient Forms
At Back in Motion Physical Therapy, we want to maximize your time with us. Prior to your first visit, please follow the steps below:
In-Clinic or At-Home Visit:
Click on New Patient Forms, fill out and submit online.
- New Patient Online or Printable Forms
- New Patient Online or Printable Forms – Spanish
- Notice of Privacy Practices
- Notice of Privacy Practices – Spanish
Virtual Visit:
Click on the Patient Form that applies to you, fill out and submit online.
First Time or Returning:
Patient Information & Consent Forms
Medicare & Self-Pay:
Currently Being Seen:
Virtual Visit Consent for Treatment
*Note: Based on insurance there may be additional paperwork