Scheduling

Return patients, please use the button above to schedule; new patients complete the form below.

* Please note no-show appointments and late cancellations (within 24hrs) will automatically be charged $150.

For your first appointment we ask that you please complete the form below so we can verify your benefits and get you set for your evaluation.

Name

First Name

Last Name

Email

Date of birth

MM

DD

YYYY

Phone#

Reason for Visit

Please let us know a brief desciption of why you are seeking physical therapy services

Insurance (if applicable)

*Out of Network only. We do not accept medicare/medicaid, no fault or workers comp

Insurance Member ID#

Sex

Required for insurance only, as recognized by your insurance company

Gender Identity

(Optional) Please feel free to include your preferred pronouns

PPTC or BTC members

Please include membership ID