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Patient Info / Forms

Whether you use your healthcare credit card to pay for deductibles, or for treatments and procedures not covered by insurance, CareCredit helps make the health, wellness, and beauty treatments and procedures you want possible today.

Thank you for choosing Austin Physical Therapy for your rehabilitation needs! As a new patient to our clinic, we understand that your time is valuable. We want to be as efficient as possible to make sure every second you spend with us is worthwhile. By providing our Intake and Health Screen forms below, you can download and fill these out at your convenience prior to your first appointment and bring in to your first visit.

Are you coming in for a FREE Consultation? 

This field is for validation purposes and should be left unchanged.
Name(Required)
YYYY dash MM dash DD

Are you coming in as a New Patient? 

Please download the forms below:

1Patient Information Form

Patient Information Form

2Patient Health Screen

Patient Health Screen

Are you a Doctor referring a patient?

Please download the form below

Note: If you try and print as a pdf from the website, pages may overlap. We suggest downloading pdf to your computer, then open and print from Adobe Reader.

1Referral Form

Referral Form

(Forms are in .PDF format and can be viewed using Adobe Reader)