Your time is valuable! We are providing paperwork here for you online to bring to your first appointment. Please fill out these documents and bring them with you when you come in for your first appointment. Occasionally, different insurance companies require additional information that you may need to complete upon check-in, but filling out these forms will help alleviate at least some of the required paperwork.
New Patient Packet
To get started in PT, fax your order to (817) 727-4319 or email us at newpatient@premierrehab.org
Private Insurance Forms
Please download the form packet based on your particular injury - back, neck, lower extremity (hip/knee/leg/ankle/foot), or upper extremity (shoulder/arm/hand/wrist). Then, print the form packet, fill it out completely and bring it to your first office visit.
Medicare Forms
Please download the form packet based on your particular injury - back, neck, lower extremity (hip/knee/leg/ankle/foot), or upper extremity (shoulder/arm/hand/wrist). Then, print the form packet, fill it out completely and bring it to your first office visit.
United Healthcare Forms
United Healthcare requires different patient forms. Please download the form packet based on your particular injury - back, neck, lower extremity (hip/knee/leg/ankle/foot), or upper extremity (shoulder/arm/hand/wrist). Then, print the form packet, fill it out completely and bring it to your first office visit.
Direct Access Forms
Direct Access patients, please download these forms. Then, print the form packet, fill it out completely and bring it to your first office visit.
Physician Prescription
- Physician Prescription Form - some insurance companies may require your physician to complete a physician prescription. Please download it, have your physician complete it and fax it to the location where you have your appointment.
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