BLOOMINGTON
4651 W Vernal Pike, Bloomington, IN 47404
Tel: 812-332-7529 • Fax: 812-339-7529
BEDFORD
3307 Mitchell Rd. Bedford, IN 47421
Tel: 812-329-6271
New Patient Information
What to expect
At your first visit with us you will see one of our licensed Physical Therapists who will evaluate you and determine the best plan of care that suits your needs. Please feel free to ask any questions you might have at any time during your treatment. We want you to have the best possible experience with our staff and be confident and comfortable with the treatment plan created at your initial visit.
Forms
Below are forms for our new patients. You can expedite your check in process by completing the patient intake form and appropriate questionnaires and bringing the completed forms to your initial appointment.
Patient Intake Forms
Pelvic Floor Intake Forms
Shoulder Pain Questionnaire
Neck Pain Questionnaire
Low Back Pain Questionnaire
Lower Extremity Questionnaire
Billing and Collections Policy
Financial information
If provided with your medical insurance, we will bill your insurance company and bill the remaining balance not covered by insurance to you. Copays are collected at each visit. Upon checking benefits, if your calendar year deductible has not been satisfied, we may ask that you pay each visit the approximate amount insurance will pass to your deductible. This is for your benefit to avoid accumulating high balances. We also offer private pay rates if you do not have insurance or choose not to bill them. These are time-based discounted rates that are due before each visit. Please feel free to ask our staff any questions you have regarding our financial policies.