Patient Informational Forms
To make your
experience with our office as convenient as possible we
provide forms that may be completed in the comfort of your
home and are available 24 hours a day! All of our
patient forms may be completed "online". Patient forms
that require a signature should then be printed to your
local printer. Those forms should then be signed and
dated and brought with you to your next visit. I am
sure that you will agree that filling out forms at your home
or office is very convenient.
This is just one more way that we can show you your
experience at The Rehabilitation Center will be second to
none!
(Most forms require Adobe PDF Reader, see below for details)
*New Patient Forms
-
Patient Information (Non-Medicare Form)* OR (Medicare Form)*
- Insurance Verification Request
- Appointment Request Form
- Prescription (To be taken to follow-up MD appointment)
- Records Request Form (From another medical practice)
- Records Release Form (From The Rehabilitation Center)
Our
goal is
to provide "Outstanding Patient
Care". Please take a moment to fill out one of our
Patient Satisfaction Surveys. In an effort to be
GREEN
our survey may be filled out "online" and submitted by
email or printed to your local printer and mailed to The
Rehabilitation Center.
Take a look at the the results of our of our online survey!
Employee/Volunteer Forms
Select here to go to our employee and volunteer forms page.
About Adobe PDF Files:
Some of our Patient Information Forms are in .PDF format, a file that is associated with Adobe Acrobat. For help on viewing, editing, and printing Adobe PDF files, please visit Adobe's website located below: (Free Download!)
