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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.
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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
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