Prior to your first appointment with us, we request all applicable paperwork be completed ahead of time. Following is a list of the items we need prior to beginning therapy:
- Prescription from your child’s primary care physician
- New Patient Intake Form – This form can be downloaded below or obtained at our office.
- Privacy Policy –This form can be downloaded below or obtained at our office.
- Insurance/Medicaid
- Insurance Information – Please provide a copy of the front and back of your insurance card for primary and any secondary insurance.
- Insurance Preauthorization – Please check with your insurance company to see if they require preauthorization (if preauthorization is required, you will need to go through this process prior to beginning therapy).
- Medicaid Information – If applicable, a copy of Medicaid card and a copy of the current month’s eligibility form.
You may bring these items to our office or send via fax, email, or mail. Have questions? Contact us by phone at (251) 450-0070 or by email using our contact form.
Pediatric Physical Therapy of Mobile has made our patient forms available for you to download, review, and complete at your convenience. Simply click on the link below to download and print a PDF of our patient forms packet, and bring the completed patient forms to your appointment.
For your convenience, we have made our Privacy Policy available for download. Paper copies may be obtained at our office.