Appointments: (410) 991-6978

  • Home
  • About Us
  • Physical Therapy
    • Treatment Techniques
    • Dance Physical Therapy
    • Injuries
    • Seniors
    • Virtual
  • New Patients
  • Resources
  • Contact
  • Covid-19
  • More
    • Home
    • About Us
    • Physical Therapy
      • Treatment Techniques
      • Dance Physical Therapy
      • Injuries
      • Seniors
      • Virtual
    • New Patients
    • Resources
    • Contact
    • Covid-19

Appointments: (410) 991-6978

  • Home
  • About Us
  • Physical Therapy
    • Treatment Techniques
    • Dance Physical Therapy
    • Injuries
    • Seniors
    • Virtual
  • New Patients
  • Resources
  • Contact
  • Covid-19

We Love New Patients!

New Patients

New Patient Intake Forms

New Patient Intake Forms

New Patient Intake Forms

We can't wait to meet you and help you heal your body and move better!  

Complete the forms below and you'll be one step closer to getting started!

Download New Patient Forms

Virtual Appointments

New Patient Intake Forms

New Patient Intake Forms

Begin your previously scheduled virtual appointment here.

Begin A Scheduled Virtual Appointment

What to Bring

To make your first visit as easy as possible, please bring the following:

  • Insurance card, 
  • Drivers license, 
  • Doctor's prescription or referral (not required in Maryland, unless you have Medicare or specific rules in your insurance plan), 
  • Xrays or MRI reports, if applicable 
  • Download appropriate forms/files below (HIPAA doesn't have to be printed, just used as a reference)

What to Wear

Please wear loose fitting clothing with ability to expose the affected area

Accepted Insurances

  • Medicare (and Medicare supplement plans)
  • All Blue Cross Blue Shield plans
  • Auto Insurance
  • Worker's Compensation


We also accept patients with out-of-network benefits, if your insurance is not listed above.  Payment is collected up front but we will file the claims directly to the insurance company for you.  We also offer self-pay options for those without insurance coverage.  Please contact us for further information so we can help you get on your road to recovery.

New Patient Packet

Health History (pdf)

Download

Consent to Treat (pdf)

Download

Consent for Telehealth Services (pdf)

Download

HIPAA Policy - No Need to Print (pdf)

Download

Low Back (pdf)

Download

Neck (pdf)

Download

Upper Extremity (pdf)

Download

Lower Extremity (pdf)

Download

Dancer Survey (pdf)

Download

Hypermobility (pdf)

Download

 We strive to maintain accessibility standards for all.  We are currently working on updating our website, but please feel free to reach out to us directly if you have any questions or need assistance.
 

Copyright © 2021 Perform for Life Physical Therapy - All Rights Reserved.

Site Design by Ideas360LLC.com

  • Home
  • Treatment Techniques
  • Dance Physical Therapy
  • Injuries
  • Seniors
  • New Patients
  • Resources
  • Contact

Cookie Policy

This website uses cookies. By continuing to use this site, you accept our use of cookies.

Accept & Close