Complete all fields to the best of your ability.
The DOB field is a little tricky. It needs dashes (" - "), not slashes (" / ") between the 2-letter month, 2-letter day, and 4-letter year.
- 0/10 (no pain)
- 1/10
- 2/10
- 3/10
- 4/10
- 5/10
- 6/10
- 7/10
- 8/10
- 9/10
- 10/10
- No elements found. Consider changing the search query.
- List is empty.
- Referral from Medical Provider
- Referral from Another Business
- Referral from a Friend
- Facebook Ad
- Walk In
- Other
- No elements found. Consider changing the search query.
- List is empty.
- Mint Hill Office
- Mobile Therapy
- No elements found. Consider changing the search query.
- List is empty.
There are two final things we need to take care of. First, how would you like to pay for your physical therapy services?
Perfect! We will have our billing team call to get your exact cost and coverage before your first visit.
The last thing we need to do is finalize some information (& give you some homework... already!):
In the next 10 min or so, I'm going to send you an email; it will be directly from our medical records system.
It has all the paperwork (consent form, medical history) to complete before your visit so we can get right to work.
Your therapist is going to send you a text message within the next hour or so with all of the other information you will need (address, etc.).
If you choose not to fill out your paperwork online please show up to your appointment 15 minutes early so we can assist you and complete all documentation needed.
We look forward to seeing you at your evaluation!
I Consent to Receive SMS Notifications, Alerts & Occasional Marketing Communication from company. Message frequency varies. Message & data rates may apply. Text HELP to (704) 905-1333 for assistance. You can reply STOP to unsubscribe at any time.