NEW PATIENT INFO (Copy)

Become a Physical Therapy Patient

New Patient Info

New patients have 2 options for providing us with information concerning your health, history and insurance. 

With either option Medicare beneficiaries MUST COMPLETE the Medicare 2nd Payer Form. 

Option 1:  Print and Complete Consent Form AND Complete Online Patient Registration. 

OR

Option 2:  Print and Complete Patient Information AND Patient History Forms.

If you are on Medicare then you also have to fill in the Medicare Second Payer Form

Medicare Patients

All Medicare patients must fill in the additional Medicare Second Payer Form

Medicare Information

Please download this form and fill it in prior to your appointment.

Download Medicare Second Payer Form

NEW PATIENT INFO

Option 1

Patient Consent Form

Patient Consent Form

Print and complete the Patient Consent Form. 

Download Consent Form

OPTION 1:  Complete Online Patient Registration AND Print and Complete Consent form.

Online Patient Registration

Online Registration

Complete Online Patient Registration.

Online Patient Regisration

OPTION 1:  Complete Online Patient Registration AND Print and Complete Consent form.

Option 2

Patient Information Form

Patient Information Form

Print and Complete Patient Information Form.

Download Patient Information Form

OPTION 2:  Print and complete Patient Information form AND Patient History form.

Patient History Form

Patient History Form

Print and complete Patient History Form.

Download Patient History Form

OPTION 2:  Print and complete Patient Information form AND Patient History form.

First Visit

Physical Therapy Visit Preparation

  • Wear loose fitting clothing or bring shorts or sleeveless shirt
  • Bring health insurance card(s) or policy information
  • Bring referral or prescription from physician. This may have been faxed or mailed to us.
  • Please bring completed forms prior to first appointment

What to Expect at Your First Physical Therapy Visit

Our friendly front office physical therapy staff...
  • Will register you on your first appointment.
  • Will assist you with understanding your insurance coverage and benefits.
 Second, our physical therapist will perform initial evaluation...
  • Physical therapist will ask questions about your medical history, current pain, or injury. Open communication helps us understand your problem.
  • Your movement, strength, coordination, and much more will be evaluated. 
  • Your physical therapist will recommend a treatment plan.
 After initial evaluation...
  • Your physical therapist will discuss the specifics of your treatment plan.
  • Treatments may be performed on the first day.
In addition...
  • Your physical therapist will communicate your treatment plan with your referring physician.
  • Your physical therapist may provide a report to you or your caregivers for home management. 
  • Service Animals vs Pets: Due to potential of injury to patient/staff/others and potential for soiled property, Southwind will limit animals (attending with patient/family) to service animals only.      
    • a. When/if requested, patient must provide documentation of “training” or certification as a service animal
    • b. Traditional pets are unnecessary and not allowed.
If you have any questions at any time, please don’t hesitate to call, 785-825-2323. 

We want to ensure your satisfaction and full recovery.
Cancellation and No Show Policy
Regular attendance is necessary for the best possible outcome of your rehabilitation.
If you are unable to attend, please give us 12 hours advanced notice of a cancellation.
 If repeated no shows or cancellations occur, a $25 fee will be charged per missed appointment.
Thank you for your cooperation.
Sincerely,
David Sanderson PT, President

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