New Patient Forms

In order to save time on your first visit to PSPT, you can download the various forms you’ll need before we can begin your manual therapy treatment. Simply download the PDF forms, print, fill out and bring with you to your appointment. This will help to save time when you arrive for your appointment and begin your therapy treatment more quickly.

The PDF download includes the following necessary forms:

  • Privacy Statement
  • Patient Agreement Form
  • Patient Authorization
  • Medicare Secondary Payer (MSP) Screening Form
  • Medicare Patient Therapy Questionnaire

Download the Complete Set of New Patient Forms (340kb)

PSPT Download All New Patient Forms

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