New and Returning Patient Forms

HOW DO I DOWNLOAD AND SIGN FORMS?

New and Returning patients select the ORANGE BUTTON below that pertains to the body region we will be treating. You can download them as a PDF (Portable Document Format) or as a Word document. All forms must be downloaded, filled out, and signed BEFORE your first session. Intake Forms help us process your claim with your insurance company and expedite payment of your claim. 

(CLICK HERE to download Adobe Acrobat for free to view PDFs). 

DOWNLOAD AS PDF

DOWNLOAD AS WORD FILE

WHAT DO I BRING TO MY FIRST APPOINTMENT?

  1. All filled out forms unless you email them to us ahead of time. 

  2. All insurance cards.

  3. Doctor's referral and related office visit notes for issues we are treating.

  4. Any related treatment protocols, surgical notes, Xrays, MRIs and CDs if available.

  5. Shoulder and Neck patients: bring or wear a tank top to expose the treatment area

  6. Lumbar or Lower Extremity patients:  bring or wear shorts to expose the treatment area.

DO RETURNING PATIENTS NEED TO FILL OUT FORMS?

YES, returning patients  MUST download, fill out, and sign  the same forms as a new patient. Each evaluation and treatment period is viewed as a separate legally binding contract between Flaming PT and you. We understand that this is extra work for you.  Thank you assisting us in this process.

DO TELETHEALTH PATIENTS HAVE ANY EXTRA FORMS?

YES, Telehealth patients also need to download, fill out, and sign a "Telemedicine Patient Consent Form" found included with each diagnosis button. You can also download it by clicking on the button below.

DOWNLOAD AS PDF

DOWNLOAD AS WORD FILE

WE ACCEPT MOST MAJOR MEDICAL PLANS:

This includes, but is not limited to:

  • Anthem

  • Medicare

  • Aetna

  • Cigna

  • Martins Point (Generations Advantage, US Family health Plan)

  • Harvard Pilgrim

  • VA

  • MEMIC and other Worker's Compensation

  • Community Health Plans

  • Tri-Care

  • Federal BC/BS

  • United Healthcare

  • At your first appointment with us, we will verify your benefits with your individual policy. This will be reviewed with you so we can answer any questions you might have. If you do not see your insurance listed here, please call us as we accept many more.

 

 

Call us at: (207) 442-9810 if you have any difficulty or prefer to have forms emailed or mailed to you.

contact us:

11 ELSINORE AVENUE

BATH, ME 04530

(207) 442-9810

68 CHAPMAN STREET
DAMARISCOTTA, ME 04543

(207) 563-7990

important links:

HOURS OF OPERATION:

M-F:  8:30AM - 6:00PM

EMAIL:

OFFICE@FLAMINGPT.COM

FAX: (207) 443-9189

TELEHEALTH

MANUAL THERAPY

PATIENT FORMS

ACCEPTED INSURANCES

Flaming Physical Therapy

ORTHOPEDIC AND SPORTS PHYSICAL THERAPY

© 2020 Flaming Physical Therapy. All rights reserved.

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