Physical Therapy

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1.866.974.2673

Physical Therapy Clinic Patient Forms

You should prepare for your first Physical Therapy clinic visit by filling out the following forms. If you will be utilizing a different insurance provider for physical therapy that is not listed here, your forms will be available for you when you come into the physical therapy clinic. If you have any questions, please feel free to call our office at 623.537.5661 and we would be happy to help.

You should prepare for your first Physical Therapy visit by filling out the following forms. If you will be utilizing a different insurance provider for physical therapy that is not listed here, your forms will be available for you when you come into the office. If you have any questions, please feel free to call our office at 623.537.5661 and we would be happy to help.

Medicare
Authorization for Treatment
Explanation of Medicare Benefits
Explanation of Insurance Benefits
Assignment of Benefits and Financial Policy

Worker's Compensation
Authorization for Treatment
Assignment of Benefits and Consent for Payment

Contact The CORE Institute today for more information about our physical therapy clinic, our mission, patient and visitor information, our research and more.

The CORE Institute

18444 N. 25th Ave.
Suite 320
Phoenix, AZ 85023

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