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Physical therapy forms template 2025

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The document is a Physical Therapy Medical History Intake Form designed to collect comprehensive medical data from patients. It includes sections on medical history, symptoms, pain assessment, assistive devices, and personal health concerns. The form aims to evaluate the patient's condition and its impact on daily activities, facilitating effective treatment planning.

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Click ‘Get Form’ to open the Physical Therapy Medical History Intake Form in the editor.
Begin by filling out your medical history. Indicate any conditions such as cancer, diabetes, or heart disease by checking the appropriate boxes.
Provide details about prior surgeries and your current occupation. This information helps therapists understand your background.
In the symptoms section, specify when your symptoms started and whether they are related to deployment. Use checkboxes for clarity.
Rate your pain levels over the past 72 hours in the designated areas, marking your responses clearly on the scale provided.
Complete any additional sections regarding assistive devices, allergies, medications, and emotional health concerns as applicable.
Finally, sign and date the form at the bottom to confirm that all information is accurate before submitting it.

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Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

What are the four main types of physical therapy?

Stretching. Strength training (with or without weights or exercise equipment). Massage. Heat or cold therapy.

How to write a script for physical therapy?

Components of a Physical Therapy Prescription A written explanation of the chief complaint or reason for the need for physical therapy intervention. Recommended frequency of treatment. Authorized length of the plan of care. Name, signature, and license or identification number of medical practitioner authorizing care.

What is the best form of physical therapy?

What is the best form of physical therapy? The best type of PT depends on individual needs, whether sports rehabilitation, neurological therapy, or pulmonary rehab. A personalized treatment plan designed by a physical therapist ensures the best outcomes based on specific health goals and conditions.

What is a PTA vs PT vs DPT?

Here are some common types of PT: Orthopedic PT: Orthopedic PT focuses on musculoskeletal injuries and conditions, such as fractures, sprains, and joint replacements. Neurological PT: Neurological PT deals with neurological disorders like stroke, Parkinsons disease, spinal cord injuries, and multiple sclerosis.

What is required in physical therapy documentation?

Though your physical therapy documentation may expand as a patient continues along an episode of care, general components of quality physical therapy documentation examples include: Patient details (DOB, name, physician contact information) Medical diagnosis. Past medical and PT treatment history.

free physical therapy documentation templates

Physical Therapy Intake form pdf Physical therapy Intake form template Massage intake form word doc Printable short massage intake Form

How to create a patient form?

Essential Information to Include in a Patient Registration Form Personal Information. Full Name (First and Last Name) Emergency Contact Information. Emergency Contact Name. Medical History Current Health Status. Existing Medical Conditions. Insurance and Payment Information. Appointment Preferences. Terms and Agreements.

How to treat knee pain in physiotherapy?

A DPT, Doctor of Physical Therapy, is now the entry level for the professional degree for physical therapists. A PTA, Physical Therapist Assistant, is an associate-degreed and licensed healthcare professional that works under the direction and supervision of a PT.