top of page
patient forms

After scheduling your appointment, please complete each form, print out and bring with you on your appointment day.
All patients must fill these forms below:
*For medicare patients only.
Additional forms may be needed:
A direct access form is needed if you do not have a Doctors prescription upon your first visit.
*For medicare patients only.
An advanced beneficiary notice is needed if you use Medicare but do not decide to submit your Physical Therapy bill to Medicare.
You can fill this form out at your initial visit.
contact us
visit us
Monday - Friday
8:00 AM - 6:30 PM
Tel. 212-541-8450/212 - 541 - 1606
Fax. 212-541-8582
53 Columbus Ave
Suite 4
New York, NY 10023
subscribe
bottom of page