Physical Therapy Forms
Physical Therapy Forms (14 Outpatient and 2 Inpatient) and PT Massage Certificate available free to download for your medical office...
The free medical forms for Physical Therapy below are free and can be modified to fit your small business or department.
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.
Physical Therapy Massage Certificate is available free to download and print. Just click the link above to access the certificate.
The goal of Physical Therapy is to make daily tasks and activities
easier (walking, going up stairs or getting in and out of bed).
Physical Therapy (PT) department mostly consists of physical
therapists, physical therapist assistants, and physical therapy aides.
companies (hospitals) have 2 or even 3 areas of Physical Therapy
including outpatient, inpatient and home health. The Home Health Physical Therapy
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 Cold Pack - This form explains to the patient how to make their very own cold pack at home.
- Physical Therapy Courtesy Call List - This form is to be filled out by the person in charge of making courtesy calls to remind the PT patients of when their next visit is. Fill in the patient name, patient phone number, yes or no to leave a message if no answer and frequency of PT visits.
- Physical Therapy Disaster Call List - Fill this list out with the people (starting with the first one called) who will be called if there was a disaster or a disaster drill then hang on your PT wall and/or designated notebook for easy access.
- Physical Therapy Work/School Note - This form is filled out and signed by PT/PTAs for patients who need note for school or work.
- Proof of Physical Therapy Treatments - This form is filled out and signed by PT/PTAs for patients who need proof of PT visits.
- Physical Therapy Patient Sign In Sheets - These forms are what you have the patient sign when they first arrive to the OP PT Office before receiving treatment. This form is a legal part of their medical record and it is proof that they received physical therapy treatment on various dates.
- PT Inservice Sign In Sheet - This form is used for your PT Inservices to have everyone in the meeting to sign for proof of PT Inservice.
- PT Pain Intensity Scale - You can print this pain scale to help your patients determine exactly how to rate their pain from a scale of 1 to 10.
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 Physical Therapy 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
Physical Therapy Cold Pack Instructions
Physical Therapy Courtesy Call List
Physical Therapy Disaster Call List
Outpatient Physical Therapy Work/School Note
Proof of Physical Therapy Treatments
Physical Therapy Patient Sign In Sheets
PT Inservice Sign In Sheet
PT Pain Intensity Scale
Inpatient PT Forms
Inpatient Physical Therapy Evaluation
Inpatient Physical Therapy Notes
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