Patient Forms - FYZICAL Therapy & Balance Centers PBC Preview on Page 1

Patient Forms - FYZICAL Therapy & Balance Centers PBC 2026

The document outlines the Florida Patient's Bill of Rights and Responsibilities, detailing the rights patients have while receiving medical care, such as being treated with respect, receiving information about their treatment, and the right to refuse treatment. It also specifies patient responsibilities, including providing accurate health information and following treatment plans. Additionally, it includes client information forms for therapy services at FYZICAL®, consent for treatment, and a health questionnaire to assess patient conditions.

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Click ‘Get Form’ to open it in the editor.
Begin by filling out your personal information in the Client Information section. Include your last name, first name, middle initial, address, and contact details.
Indicate your date of birth, sex, and social security number. This information is crucial for your medical records.
Complete the Emergency Contact section with a name, phone number, and relationship to you.
In the Consent for Treatment section, read carefully and provide your signature to authorize therapy services.
Fill out the Client Health Questionnaire by describing your current complaint or limitation and any relevant medical history.
Review all sections for accuracy before submitting. Ensure that you have acknowledged receipt of the Florida Patient's Bill of Rights.

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Does fyzical accept Medicare?

FYZICAL Therapy and Balance Centers accepts most major insurances including but not limited to: Medicare, BlueCross BlueShield, Aetna, Cigna, United Health care, Tricare, Railroad Medicare, Humana, Allied, Workers compensation plans, Auto insurance, personal liability insurance and self-pay.

Does Medicare pay for physical therapy for seniors?

Medicare pays for inpatient and outpatient physical therapy services, but it does not cover the full cost. An individual will usually need to pay a deductible and copayment. Physical therapy can help people regain movement and reduce pain and discomfort due to injuries, chronic conditions, or disabilities.