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New or updated Patient Form

New or Updated Patient Information

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Dear New Patient, Welcome to Horizon Physical Therapy, PC. We are excited you have chosen us for your physical therapy needs. Your therapist will differentially diagnose your problem through assessment and perform neuromuscular re-education to maintain a pain free state after you are discharged. Manual therapy/hands on treatment will be provided in a relaxed therapeutic environment. It is part of our mission to ensure that you are fully satisfied with your care, and everyone at our clinic will work hard to make your experience exceptional. Important information: - If you did not complete the admission forms prior to your visit, please complete them now. - We will need a copy of your insurance card and driver's license as well as the prescription from your doctor. - If your insurance requires you to pay a copay and/or coinsurance, please plan to pay this at each visit. - You may be asked to wear shorts if you are being treated for a low back, hip, or knee problem. You may bring shorts with you or use a pair from our supply. - Plan for your appointment to last 45-60 minutes. Insurance Verification As a courtesy, Horizon Physical Therapy, PC will verify your insurance benefits with your provider. At your request we will provide you with information regarding your policy allowances for physical therapy services. You will receive EOBs from your insurance company as well as a monthly statement from Horizon Physical Therapy, PC. This statement will indicate the amount that was billed to your insurance company. Please note that your insurance company will determine the amount they will pay for physical therapy services based on your policy. [You are responsible for partial or total payment of the balance. Ultimately, you are responsible for understanding the benefits and eligibility of your policy.] Equipment Charge As we do issue items such as exercise bands, noodles, balls, etc. during your rehabilitation and/or use specialized equipment for your treatment, there is a one time ten dollar fee. THIS FEE IS AUTOMATICALLY BILLED TO YOU AND WILL APPEAR ON YOUR MONTHLY STATEMENT. Insurance will not cover this fee. This fee excludes durable medical goods and special order items, which will be billed separately if needed for your care. Thank you again for choosing Horizon Physical Therapy, PC. We look forward to working with you!