To expedite your visit at Tice Valley Physical Therapy, we are providing our new patient forms below which you can complete in the comfort of your home.  These forms are provided in order to save time at your appointment. Please print and fill out all of the following forms prior to coming to your initial visit.

If you choose, you can also complete them in our office, but their submission is needed prior to your initial evaluation visit with the therapist.

These forms, along with a few additional others you will receive at the time of your first appointment, are important to allow for the evaluation and treatment of your dysfunction, and to provide us with the information that we need in order to bill your insurance if needed.

If you have any questions while completing the forms, please bring them with you to your appointment and we will be happy to assist you.

Cancellation Policy

Cancellation Policy

New Patient Registration Record

New Patient Registration Record

Health History Questionaire

Health History Questionaire

Pain Disability Index

Pain Disability Index

Patient Info Consent Form

Patient Info Consent Form