Patient Information & New Patient Forms
Introduction
As an independently owned Physical Therapy Private Practice, the owners are directly involved to ensure that you receive excellent care while you are attending Fowlerville Physical Therapy Specialists
We specialize in the rehabilitation & prevention of orthopedic & sports injuries for ALL ages, while we are best recognized for our expertise & success treating spinal related problems. In addition, our Therapists have received significant advanced training & certifications over the years which enables us to provide a no. of specialty services.
Your Physical Therapy Referral (Also referred to as a Prescription or Script)
A Physical Therapy Referral can be written by a Medical Doctor (MD) a Doctor of Osteopathy (DO) a Podiatrist (DPM) a Dentist (DDS) and more recently by a Physician Assistant (PA) & a Nurse Practitioner (NP) on behalf of a physician.
A Physical Therapy Referral is valid for 30 days from the date it is written and needs to be renewed if P.T. is not started within this 30 day period. (Exception: Medicare: 90 days)
If you believe that you would benefit from a course of Physical Therapy for a condition or injury that you have sustained, but do NOT have a referral for P.T. you can either contact your family physician and inquire if they are in favor of writing you a referral for P.T. OR contact us (especially if you do not have a family physician) and we can recommend a physician for you to see.
Of note, a no. of states will enable a patient to be evaluated and treated by a Physical Therapist without a referral from a physician; this is not presently the case in Michigan. In the state of Michigan, a Physical Therapist is legally allowed to evaluate a patient without a referral, but not provide any therapy, while the evaluation (most commonly) is NOT paid by most insurance companies, unless it is recommended (in advance) by physician.
Schedule an Appointment
We are always very pleased to have the opportunity to provide therapy at Fowlerville Physical Therapy Specialists for individuals that live & work in Livingston County & surrounding areas.
Whether this is your first time to attend for a program of Physical Therapy or you have received physical therapy in the past, we would like you to know that we are committed to ensuring that you receive excellent care.
To Schedule a Therapy Appointment:
1. Simply call our clinic at 517-223-8308 & one of our scheduling team will be available to assist you.
OR
2. If you prefer, you can fax your referral to us at 517-223-8344 & include a phone no. where you can be reached AND the best time to contact you.
When calling, please have your insurance information available including any secondary/supplemental insurance you may have. Also, if your condition or injury is auto or work related, it is helpful if you can provide us with any authorization information that you may have.
We can usually provide you with an appointment within 24 hours, while early morning, evening & Saturday appointments are available.
New Patient Forms
Please arrive for your first Physical Therapy appointment 15 -20 minutes early so we can review with you your insurance benefits & also to provide you with adequate time to complete a no. of forms (see below) prior to being seen by your Physical Therapist. If you regard your condition or medical history as complex, please arrive 20- 25 minutes early.
For your convenience, you can also download the following the forms & perhaps complete them in the comfort of your home, in advance of your initial appointment. If you choose this option, PLEASE remember to bring the completed forms to your first therapy appointment!
Medical History Form
This form should be completed by all patients, new & returning, Please print & fill out.
Medicare Secondary Questionnaire
This form should be completed by all Medicare patients. Please print & fill out.
Medication Form
This form should be completed by all Medicare patients & any other patients that take more than 3 prescribed medications. Please print & fill out.
HIPPA Compliance
This form, required by the Privacy Act describes how health insurance information about you maybe used or disclosed by our practice. Print
Financial Agreement & Consent Forms
We will contact your insurance company to verify your Physical Therapy insurance benefits & we will prepare these forms & review them with you, when you arrive for your initial appointment.
We recognize that completing these forms can take some time. However, accurate completion of these forms helps to ensure that all insurance requirements are met & your Physical Therapist has the information they need to evaluate & effectively treat your condition.
Your 1st Visit
The evening prior to your 1st therapy visit, one of our scheduling team will call & confirm your appointment.
In addition, they will:
1. Remind you to come early to review your insurance coverage & complete / review a no. of forms.
a. If you completed your forms in advance arrive only 5 minutes early
b. If you did not complete your forms in advance, arrive 15 minutes early
c. If you have Medicare insurance or your condition and/or Medical history is complex, arrive 20-25 minutes early.
2. Ask that you please bring the following items to your appointment:
a. Physical Therapy Referral (if in your possession)
b. Forms completed in advance for your 1st visit
c. A list of your current medications
d. Your Driver’s License
e. Your insurance card (s)
f. A loose fitting shirt or tank top if we are seeing you for a neck, shoulder or elbow condition
g. Loose fitting shorts or sweat pants if we are seeing you for a low back, hip, knee or foot /ankle condition
h. Your schedule /planner, so you will be able to schedule your subsequent therapy sessions
3. Confirm that you know where our practice is located
(Down town Fowlerville, beside the Fowlerville Pharmacy & 4 doors down from the Bloated Goat!)
When you arrive for your initial appointment, our front desk staff will review your insurance information & other forms to be completed or reviewed, if applicable.
Canceling or Rescheduling your Initial Appt
If you need to cancel or reschedule your initial appointment, we would ask that you call us ideally 24 hours in advance, if possible.
Your Physical Therapy Evaluation
It is important that you try to arrive on time for your initial Physical Therapy evaluation. An initial evaluation is scheduled for 1 hour & during this time, your PT will thoroughly evaluate your condition, review with you, your evaluation findings, outline a program of therapy that is best suited to your condition & goals & the results that you should expect. In addition, treatment will likely start following your evaluation & may include self care instructions & exercises to perform at home, if indicated.
Scheduling Subsequent Appointments
Your Physical Therapy Referral, your Insurance coverage & your Physical Therapy evaluation, as well as your individual circumstances all play a part in determining how frequently & for how many weeks you will need or are able to attend for Physical Therapy. Your PT will discuss this with you at the conclusion of your initial evaluation.
We recommend that you schedule all of your (approved) PT sessions ASAP (if you know your schedule in advance) as this will enable us to provide you with appointment times that will best fit your needs.
Also, we would ask in the event that you need to cancel an appointment, that you please provide us with 24 hours notice, if possible.
