Physical therapy screening form 2026

1. Click ‘Get Form’ to open the physical therapy screening form in the editor.
2. Begin by entering your personal information, including the date, name, gender, age, and smoking status. This section helps the therapist understand your background.
3. In the medication section, list any medications you are currently taking along with their doses and how they are taken. This is crucial for assessing potential interactions during therapy.
4. For past surgical and medical history, provide details about any surgeries or conditions you've had. Circle any relevant medical conditions from the provided list to give a comprehensive view of your health.
5. Describe your current symptoms in detail, including pain location and severity on a scale of 0 to 10. Use the body chart to indicate pain areas accurately.
6. Finally, identify activities that worsen your symptoms and note any aggravating factors. This information will assist your therapist in tailoring your treatment plan.

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