New Patient Registration
What To Complete Before Your First Visit
To save time when coming to our office for your first appointment, please print and complete the Patient Registration, Medical History and Financial Agreement Forms. If you are unable to download and complete these forms before your appointment, please contact us so she can make them available to you upon your arrival.
Patient Registration
Collects basic demographic form and contact information.
Medical History
Collects information on your past medical history.
Financial Agreement
Basic agreement and explanation of terms between you and our office.
If you have not completed your forms in advance, please arrive 20 minutes prior to your scheduled appointment time.
What To Bring On Your First Visit
Arrive at least 5 minutes before your appointment start time and bring comfortable workout clothing such as shorts, yoga pants and tank top for your session.
It is helpful to bring any diagnostic reports and prescription from your physician if they are available.
Fees Structure, Billing and Insurance
Back 2 Normal Physical Therapy strives to provide the highest quality patient care. As health care costs continue to rise, Back 2 Normal Physical Therapy makes every effort to maintain our standards of care. In order to honor this commitment, we are an out-of-network provider. As a courtesy, Back 2 Normal Physical Therapy will provide you with an invoice for all services rendered. You will be responsible for paying at time of service and can submit for reimbursement to your insurance company. Credit cards are currently not accepted.
Cancellations
Appointments may be canceled by calling (727) 698-1662 at least 24 hours in advance. Please do not email schedule changes or cancellations. If you have any questions prior to your appointment, please feel free to contact us.
We look forward to working with you and helping you get Back 2 Normal.
Notice Of Privacy Practices and Patient Rights Information
Authorization To Release Medical Information
This form allows us to request copies and share your medical information with authorized individuals.
Notice Of Privacy Practices
Explains your privacy rights and how we will use your information.
Patient Rights
Explanation of your rights as a patient.
Patient’s Responsibilities
Explanation of your responsibilities as a patient.
Online Communications Informed Consent
Terms and conditions of online communications with Back 2 Normal Physical Therapy.
