Patient Info / Forms
Are you living with pain, limited function or weakness? At Rose City Physical Therapy, we are dedicated to helping you identify the cause of your pain and limitations and create a custom treatment program that will allow you to return to normal activities pain-free.
To make an appointment at your convenience, simply call us today at (503) 228-1306 or click here to request an appointment.
Scroll to bottom for quick access to forms.
What to Expect from Your First Visit with Us:
Your first visit with Rose City Physical Therapy will require you to complete requisite paperwork just like at other medical providers. This includes completing an initial Intake Information form to provide demographic and insurance information , signing a Financial Policy acknowledgement form, and an Acknowledgment of HIPAA Guidelines. Call us at 503.228.1306 or email to request these forms so you can print and complete them prior to your first visit. It will expedite your check in process.
The INITIAL EVALUATION – your initial visit – consists of a comprehensive physical therapy exam, and the clinical findings will be shared with you in a way that allows an easy understanding of the problem and the treatment recommendations to help you. Emphasis on education is a vital component in the success of your recovery. Goals will be set with respect to your personal goals to get you back to doing the things you love. See below for a bullet point breakdown for more information.
- Upon your arrival, you will register with our friendly front office staff. There will be the requisite paperwork to complete like in all healthcare facilities – yes, we know…it can be exhausting; but necessary. The staff will have completed an insurance verification process and will help you navigate and understand this so you can focus on your recovery.
- You will meet with your physical therapist for the initial evaluation.
- During the INITIAL EVALUATION your physical therapist will sit down with you and learn why you are seeking treatment, what it is that is giving you problems, limitations in work, sport or play as a result, and details with regards to relevant medical history and contributing factors. Your physical therapist will ask questions about your current and past medical history, current pain or injury, and discuss what your goals are from physical therapy. Open communication helps us understand your problem and establish a plan of care to help get you back to doing the things you strive to do.
- Your functional movement, range of motion, strength, coordination, and much more will be evaluated. Our purpose is to help you. The evaluation can include special tests to load muscle, tendon and joints to help rule in our rule out problem areas, so please ensure you communicate to your physical therapist if anything is hurting or bothering you during the examination.
- Your physical therapist will recommend and prepare a course of treatments based on research and evidence to ensure the quickest recovery and the best results. This recommended plan of care will be discussed with you.
- During the initial evaluation, education is important to allow you to understand what is going on and to provide you with some home management strategies and exercises to allow you to start to help yourself – an important aspect of your recovery. There will also be some treatments performed the first day to get you started on your road to recovery. However, subsequent visits will get into the full swing of your treatment plan.
- After the evaluation is completed and your care plan discussed, you will schedule your course of care with the front desk. The course of treatment depends on the recommendations of your physical therapist and if applicable, physician or surgeon. We offer many convenient appointment times; however, prime times can become busy so it is best to book ahead as much as possible for consistency and to get appointments that best fit your schedule.
- We strive for collaboration and communication with your physician. If you were referred to Rose City Physical Therapy by your physician, your physical therapist will send a copy of your detailed evaluation and recommended plan of care to them. If you sought care on your own and would like us to send a copy of this to your physician or another medical provider you choose, we are more than happy to do so for their records.
- Call anytime with questions or ask us them when in the clinic. We strive to provide a patient centric experience and are here for you at all times to ensure satisfaction. We want to ensure your satisfaction and full recovery.
Subsequent FOLLOW-UP VISITS will provide a progression of rehab specifically curtailed to your unique needs. If you are attending physical therapy for post-surgical rehabilitation we will contact your surgeon’s office to capture any relevant surgical reports, imaging reports and post-surgical rehab protocols unique to your surgery.
Patient education and individualized therapeutic exercises and functional movement will continue throughout the course of your care and self-management homework (exercises) will be provided and is important in the overall success of your recovery. Treatment may also include manual therapy techniques (range of motion, stretching, soft tissue/myofascial release, ASTYM, joint mobilizations and/or manipulations, muscle energy, Jones Counterstrain), blood flow restriction training, balance and agility exercise, posture and body mechanics, sport or work specific functional activities, and passive modalities if and as needed.
Preparing for Your First Visit:
- A photo ID and insurance card are required. Please bring them with you and we can make a copy for your records.
- Arrive 15 minutes early for your first appointment to allow check in and time for paperwork and registration
- Have in writing your past medical history (we provide a form for this if you don’t have one prepared), previous treatments for the current condition, a list of your current medications, and other important information related to your problem(s) seeing us for.
- Make a list of questions you have and bring them with to discuss with your physical therapist during your first visit.
Ready to get started? You can complete your new patient intake forms beforehand!
To save time on your first visit, print the following patient documents below, fill them out, and bring them with you to your first appointment.
- New Patient Forms to complete:
- Current Medications
- HIPAA Confidentiality Acknowledgment
- Financial Policy (minus specific benefit page)
- Cancellation/No-show policy
Don’t have time to print them off beforehand? No worries! Simply allow extra time before your appointment to fill them out in our clinic. At Rose City Physical Therapy, we are here to help you get the most out of your visit – contact us today!
Notice of Privacy Practices
Financial Policy Form