Covering the Care We Provide

Forms

Feel free to print the PT Intake and the Office Intake forms, fill them out, and bring them with you to your first visit. All the following forms can be provided by the receptionist at Summit Physical Therapy, Inc. and may be completed the day of your evaluation if you would prefer. You may review our Patient Bill of Rights in this section as well.

New Patient Packet

Individual Forms

Patient Office Intake Form

Notice of Privacy Practice Acknowledgement

Patient PT Intake Form

No Show Policy

Patient Bill of Rights

Notice of Privacy Practices

Media Release

Telehealth Consent Form

Request an Appointment

Shoes or No Shoes, what's the difference?

September 3, 2018

The Opioid Crisis

July 16, 2018

1/3
Please reload

Homer Location

Seldovia Location

Contact

Follow

  • Snapchat Social Icon
  • Instagram Social Icon

Fax

(907)205-5370

(907)226-1111 Alternate Fax

©2018 by Summit Physical Therapy, Inc