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NEW PATIENT FORMS AND POLICIES

For your convenience, we have provided our patients forms on our website. Please download the forms and fill them out no more than 48 hours (in order to accurately assess your condition) prior to your initial evaluation and bring the forms with you along with your Health Insurance Card(s), medications list (including dosage/frequency/method of administration) and Prescription for Physical therapy when you come in for your initial appointment. If you choose to fill out the patient forms at our office, please arrive 15 minutes before your appointment to allow enough time to get them completed.

Please feel free to email at nspt@northshorept.com or call us if you have any questions and/or require assistance.

Our friendly staff will gladly assist you


NEW PATIENT INTAKE FORM AND MEDICATION LIST

NOTICE OF PHI

Our forms are PDF files.   BE SURE TO COMPLETE BOTH PAGES.

To download and print the forms, you'll need the free Adobe Acrobat Reader program.

PATIENT PAYMENTS AND CANCELATION POLICY

Co-pays, Deductible, and Co-Insurance are per visit

and due at the time of each appointment.

If you prefer to be billed, there will a one-time $10 bill processing fee (per condition/case).

Our front office staff will do their best to help you understand you payment structure.  However, it is the patient’s responsibility to know what their benefits are and what their payment per visit will be. 

North Shore Physical Therapy is NOT responsible for any inaccurate estimates made.  

WE REQUIRE 24-HOUR NOTIFICATION FOR APPOINTMENT CANCELLATIONS

At North Shore Physical Therapy, we are proud of our one-on-one treatment approach; we never double-book patients.  This approach allows our patients to have the Therapist’s constant undivided attention.  With proper notification, most cancelled appointments can be easily filled.  However, with less than 24 hours notice it is difficult to fill the vacant time slots created by cancellations. 

Effective June 1, 2017, we assess a $30 fee for appointments missed or cancelled with less than 24 hours notice. 

We reserve the right to offer your slot to another patient if you are 15 min

late and have not notified the office. 

Patients who miss appointments or cancel with less than 24 hours notice three (3) times will have their future visits removed and will not be allowed to schedule ahead.  Those patients may call on any day to see if there is an available times slot with their Therapist.

We never penalize cancellations with more than 24 hours notice. 

Thank you for choosing North Shore Physical Therapy