New Patient Forms 2018-01-25T04:10:50+00:00

New Patient Forms

Thank you for your consideration of Therapy Works, PC. Let’s get started!

Attention Parents/Guardians: This file must be saved to your desktop before and after completing!

Step 1

Complete the New Patient Packet (Click on link to launch fillable PDF)
These include the following:

  • PATIENT CASE HISTORY FORM (2 pages)

  • PATIENT CONSENT FOR USE/ DISCLOSURE OF HEALTH CARE INFORMATION

  • BILLING INFORMATION

  • ATTENDANCE POLICIES AND PROCEDURES

  • IEP/IFSP FORM

Step 2

Email this document to referrals@therapyworkspc.com (You will need to sign on your visit)
or
Print out and complete the signature pages. Bring these forms with you to the office for your first appointment.