Physical Therapy Professional Services Log - Leader Services 2026

1. Click ‘Get Form’ to open the Physical Therapy Professional Services Log in the editor.
2. Begin by entering the MA # / Client ID # and Student # at the top of the form. This information is essential for identifying the client.
3. Fill in the Student name and School district fields to ensure accurate record-keeping.
4. Specify the Service month/year and NPI #, which are crucial for billing and service tracking.
5. In the Provider name (print) section, clearly print your name, followed by the Service date, DOB, Time in, Time out, and Total time in minutes. Ensure accuracy for compliance.
6. Select the appropriate CPT code from the provided list based on services rendered during this session.
7. Document any relevant Treatment notes that reflect progress or challenges faced during therapy.
8. Finally, both Provider and Supervisor signatures are required below. Ensure you include your Title and Date next to your signature for validation.

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