MINOR INITIAL VISIT CHECKLIST

Did You Complete the Following?

  • Complete, the Body One Physical Therapy Minor Patient Information Form and read, sign and date the Missed Appointment Policy section of the form?
  • Read, sign and date the Minor Patient Treatment Consent Form?
  • Read, sign and date the HIPAA Consent Form?
  • Read, sign and date the Financial Policy Form?
  • Complete, sign and date the Medical History Form?
  • Complete, sign and date the Medication List?
  • Please bring all of your completed paperwork (see checklist above) and arrive 10 minutes prior to your scheduled appointment time. If your paperwork is not complete, please arrive 20 minutes prior to scheduled appointment time.
  • A parent or adult guardian must accompany the patient for their first appointment.
  • If your physician ordered physical therapy, please bring a copy of the order or prescription, if it has not already been sent to our office.
  • Please bring your insurance card(s).
  • Please bring a photo identification (Driver’s License, etc…).
  • Be prepared to pay for your required patient financial obligation (copay, deductible, or coinsurance).
  • Dress appropriately and comfortably (t-shirt or sports bra for upper body and sweatpants or shorts for lower body) for assessment, treatment and exercise.

Download New Minor Patient Forms

MINOR INITIAL VISIT CHECKLIST

Did You Complete the Following?

  • Complete, the Body One Physical Therapy Minor Patient Information Form and read, sign and date the Missed Appointment Policy section of the form?
  • Read, sign and date the Minor Patient Treatment Consent Form?
  • Read, sign and date the HIPAA Consent Form?
  • Read, sign and date the Financial Policy Form?
  • Complete, sign and date the Medical History Form?
  • Complete, sign and date the Medication List?
  • Please bring all of your completed paperwork (see checklist above) and arrive 10 minutes prior to your scheduled appointment time. If your paperwork is not complete, please arrive 20 minutes prior to scheduled appointment time.
  • A parent or adult guardian must accompany the patient for their first appointment.
  • If your physician ordered physical therapy, please bring a copy of the order or prescription, if it has not already been sent to our office.
  • Please bring your insurance card(s).
  • Please bring a photo identification (Driver’s License, etc…).
  • Be prepared to pay for your required patient financial obligation (copay, deductible, or coinsurance).
  • Dress appropriately and comfortably (t-shirt or sports bra for upper body and sweatpants or shorts for lower body) for assessment, treatment and exercise.

Download New Minor Patient Forms