Downloadable and Fillable Forms

Below are some links where new, current, and previous patient can download and fill out. It is a PDF file where anyone can type on the forms, save, and print out. Just click on Download English or Download Espanol. The page will change to the corresponding forms. You can then save or print it afterwards.

 

Medical History Form

This form is vital that we get the correct information about your medical history so that PTHC’s Physical Therapists can make proper evaluation, consultation, and proper planning for your treatments.

Download English   

Download Espanol 

 

Finance Policies

Please read, review, and sign this as it is required by PTHC staff in order to start your initial evaluation and follow up treatments. This form can clarify all questions regarding future billings as who is responsible for payments initially and later on.

Download English  

Download Espanol 

 

Patient Information Practices

Please read, review, and fill out this form as it is required by PTHC staff to start your initial and follow up treatments. This form provides information on disclosure, patient individual rights, concerns and complaints, and patient information acknowledgements.

Download English  

Download Espanol