Common Contracts
2 similar Patient Agreement contracts
Dry Needling • Vertigo • Spine & Sports Rehabilitation • Pediatrics • Pelvic Health • And more!Patient Agreement • August 21st, 2024
necessary for my diagnosis. I understand that my physical therapy care and treatment may be provided by a physical therapist or physical therapy assistant. I am aware that there are certain risks involved with a physical therapy program. Every effort is made to minimize my risk by continuous assessment of my condition throughout my therapy. I will inform my therapist of any changes in my medical condition, or medications, as they may necessitate change in my therapy program. I will stop any
Dry Needling • Vertigo • Spine & Sports Rehabilitation • Pediatrics • Pelvic Health • And more!Patient Agreement • August 16th, 2024
Consent for Treatment: I have a condition requiring physical therapy intervention, and consent to the delivery of such care. I understand that my medical care and treatment may be provided by a physical therapist or physical therapist student intern. In order to improve my physical condition in regards to pain, range of motion, strength or another type of physical impairment, I consent to enter Primetime Physical Therapy program for evaluation and treatment. I request and authorize the licensed staff of Primetime Physical Therapy to render treatment, and to perform appropriate procedures that my referring provider may deem reasonable and
