Please click on the forms below, print and fill them out, then bring them with you to your first appointment. For your convenience some forms can be filled on the computer before printing them. Please do not forget to sign them! If you have questions about the paperwork, please call our office or arrive to your appointment a few minutes early.
We also include access below to our therapy prescription form. It features a general list of our services, location maps and contact information. Please remember, you have a choice when seeking care. Freedom provides superior quality therapy at a terrific value, and a broad range of services to meet all of your Physical and Occupational Therapy needs. A large number of our patients are return customers, despite the competitive health care environment we are in. Your provider may not be familiar with our services. Please take the opportunity to help educate them by asking them to fill out and sign our form when you are seeking therapy.
You will need Adobe Acrobat to view and print the forms on this page. If you do not have Adobe Acrobat (PDF), you can download it for free here.
New Patient Forms
Medical History Questionnaire
In order to serve you better it is very important for us to learn all we can about your health condition. Please take a few minutes to complete this questionnaire. Your answers will be kept confidential.
Patient Demographic Form
Please supply us with your personal and billing information. We will review your insurance coverage details together at the time of your first appointment.
Patient Consent and Medical Records Release Form
Please read through our consent form carefully so you are aware of our policies and procedures. We require our customers to read and sign this form prior to receiving treatment. The medical records release form allows us to communicate with your other medical providers in order to provide the best service to you.
Please take this to your health care provider or ask them to print it from our website, ask them to sign and return it to us, or bring the completed form with you.
What to bring to your first appointment
Please wear or bring comfortable clothing. If you’ve had medical imaging such as X-rays, CT scans, or MRI studies, actual images or reports may be helpful in establishing your care plan. Surgical reports are also very helpful to review. If you do not have these in your possession, we may request them from your provider. Please also bring any splints, appliances, braces or orthotics you are using. Finally, bring your goals and a positive attitude!