|
New Patient Forms & Procedures
Please click on the logo below if you are a United Healthcare patient.
Please click on the logo below if you are a Medicare patient.
All other patients should click on the forms link below and use your print function to print the forms. Please fill them out, and bring them in on your initial appointment.
View Forms & Print |
Note: to read the forms,
you will need the following software on your
computer. Adobe Acrobat Reader is free
software that lets you view and print Adobe
Portable
Document Format (PDF) files.
|
In order to set up an appointment
with Axiom Physical Therapy for your initial evaluation, please remember
these important steps:
| 1. |
Obtain a prescription from your
physician. |
| 2. |
If your insurance requires a referral from
your Primary Care Physician (PCP), have your
PCP's referral coordinator (nurse) fill out the
referral to Axiom Physical Therapy. |
| 3. |
If you do not have health insurance, a prescription
from your doctor is still required. |
| 4. |
After your prescription for physical therapy is obtained, call the
Axiom Physical Therapy clinic nearest you:
Please have your insurance card and
referral at hand, as our front office staff will
need this information to schedule your first
visit.
|
| 5. |
Please arrive ten minutes early
for your first visit to fill out the required
registration paperwork if you did not print
them from our web site. |
| 6. |
If you have a printer and would like to fill
out the registration paperwork before your appointment,
you may download the 4 forms listed at the top
of this page, print them and bring them to your
initial appointment. |
| 7. |
Please bring your insurance cards and prescription. You will be presented with a written
verification of your insurance limitations,
exclusions, and required payments for co-pays
and deductibles as well as your insurance
percentage responsibility. In addition
you will also be presented with new HIPAA
forms that you will need to sign.
View and Print HIPAA Notice of Privacy Practices |
|
