Patient Forms

whAT TO BRING TO YOUR FIRST VISIT:

1. Completed forms
2. Insurance card
3. Photo identification
4. Referral from your doctor (optional)

Below you will find new patient forms:

  1. Before arriving for your first appointment at Specialized Physical Therapy, please fill out the functional scale new patient form that is most applicable to your injury by clicking on the proper box below, then download, print, and complete that form.  (Our forms are PDF files. To download and print the forms, you’ll need the free Adobe Acrobat Reader program.)

  2. Please bring or email these forms fully completed to your initial physical therapy visit.

If you choose instead to fill out the new patient forms at our office, please arrive 20 minutes prior to your appointment to complete the required paperwork.

What To Wear: Comfortable clothing such as workout clothes or anything you would wear to the gym or a physically active class.

If you have any questions please feel free to contact us at 714-838-6999 or email us at info@specializedpt.com 

hand, arm, shoulder (upper extremity)

foot, leg, hip (lower extremity)