Welcome to ProActive Physical Therapy & Performance Center!

Please fill out all pages of the Medicare Intake Forms


ALSO, please select one of the following forms that best represents why you are coming for treatment.

 

                Neck Pain Form

 

                Back Pain Form

 

                Upper Extremity Pain Form  (shoulder, elbow, wrist, hand)

 

                Lower Extremity Pain Form   (hip, knee, ankle, foot)

 

                Balance Form 

                Dizziness/Vertigo Form

A physician referral is not required to start physical therapy.

Please bring your forms, along with your ID, insurance cards, and physician referral to your initial appointment.