Physical Therapy Forms

Physical Therapy forms (Outpatient and Inpatient) free to download for your small business or department with immediate access 24/7.

The free medical forms for Physical Therapy below are free and can be modified to fit your small business or department.

Physical Therapy is a type of treatment you may need when health problems make it hard to move around and do everyday tasks. This treatment is also often used after orthopedic surgery (knee surgery, shoulder surgery, etc.) to speed up and ensure the recovery effort for patients both young and old. It helps you move better and may relieve pain. It also helps improve or restore your physical function and your fitness level.



The goal of Physical Therapy is to make daily tasks and activities easier (walking, going up stairs or getting in and out of bed).

The Physical Therapy (PT) department mostly consists of physical therapists, physical therapist assistants, and physical therapy aides.

Some companies (hospitals) have 2 or even 3 areas of Physical Therapy including outpatient, inpatient and home health. The Home Health PT forms will be added soon.

The OP Physical Therapy forms below include:

  • Physical Therapy History Questionnaire - This form is used to by the PT office to give to a new patient to fill out before the Initial PT Evaluation is performed. This form will give the Physical Therapist a clearer picture of what is going on with the patient before he brings the patient in the evaluation room.
  • Physical Therapy Evaluation - This form is filled out by the Physical Therapist on the patient's initial visit. This form is filled out on the patient according to the what the Physical Therapist evaluates, and then is faxed to the patient's physician who ordered the Physical Therapy.
  • Physical Therapy Flow Sheet Weekly Note - This form is filled out by the Physical Therapist and Physical Therapist's Assistant(s) on each patient's visit to document patient's progress.
  • Physical Therapy Progress Report - This form is filled out by PT/PTAs usually before the patient has a doctors appointment to update physician via fax on PT progress.
  • Physical Therapy Discharge Report - This form is filled out by PT/PTAs after patient is discharged from Physical Therapy and is faxed to the physician who ordered the PT.
  • Physical Therapy Berg Balance Scale - This form is filled out by PT/PTAs to assess patient's risks of falls, etc. and is faxed to physician who ordered the PT.
  • Physical Therapy Work/School Note - This form is filled out and signed by PT/PTAs for patients who need note for school or work.

The IP Physical Therapy forms include:

  • Physical Therapy Evaluation - This form is filled out by the Physical Therapist performing the evaluation of the patient in the hospital. This form is then inserted into patient chart for physician review and signature.
  • Physical Therapy Notes - This form is filled out by the PT/PTAs who is performing the PT visits on the patient in the hospital. This form also is inserted into the patient chart for physician review.
Click on the link(s) to download the Free PT Forms below:

Outpatient PT Forms

Outpatient Physical Therapy History Questionnaire

Outpatient Physical Therapy Evaluation

Outpatient Physical Therapy Flow Sheet Weekly Note

Outpatient Physical Therapy Progress Report

Outpatient Physical Therapy Discharge Report

Outpatient Physical Therapy Berg Balance Scale

Outpatient Physical Therapy Work/School Note

Inpatient PT Forms

Inpatient Physical Therapy Evaluation

Inpatient Physical Therapy Notes


If you need to modify this form, try the site: Free PDF Services. You can convert this Adobe file into a Word document free of charge and make the necessary changes.

Note: You will need Adobe Reader (the latest version is recommended) installed on your computer in order to save or open these forms. You can get Adobe Reader free here (a new window will open so you can download it without leaving this page). If you want to open the file in your browser window, just click on one of the links above. However, if you want to download the file to view later, then right-click on the link and choose "Save Target As" or "Save File As". Then select where you want to save the file on your hard drive.


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