1024 Centre Ave.
Fort Collins, CO 80526

Phone: (970) 224-4141

Fax: (970) 797-1227

Same day appointments are available!

Easily fill out an appointment request here using your phone or tablet.

© 2019 by ProActive Physical Therapy and Performance Center, Fort Collins, Colorado  80526

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 

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.