NEW PATIENTS

Welcome to PEAK Physical Therapy.  We are excited to help you in your recovery process.  Here you should find all the information you need prior to your first visit.  If you have any additional questions don’t hesitate to give us a call at 810.360.0806.

PATIENT FORMS

To help make your first visit go faster, you can print then fill out all the forms we need prior to your evaluation.

Medical History

Consent To Communicate

Consent to Treat

 

 

PRE-EVALUATION SURVEY

Insurance requires patients to take a survey regarding their current symptoms.  You need to choose the survey related to the body part that is injured.  You will be filling the same survey out each month so insurance companies can see that you are improving.  Please fill them out according to how you are feeling in general so they get an accurate description of how limited you are right now.

Shoulder, Arm, Hand Pain

Neck

Hip, Knee, Ankle

Back Pain

 

PRESCRIPTION

Script Form

 

JUST A REMINDER
• Please bring this prescription/referral slip with you on your first visit.
• Please arrive 15 minutes before your scheduled appointment to complete any
necessary paperwork.
• Evaluations (1st visits) usually last 60 to 90 minutes.
WHAT TO WEAR
• Please bring comfortable clothing and sneakers including T-shirts or tank tops and
shorts or sweatpants.
WHAT TO BRING
• Driver’s License
• Insurance Card
• For worker’s compensation claim, bring employer information and claim number.