Physical Therapy Evaluation and Treatment Consent Form

Physical therapy practices need a streamlined way to gather essential patient information before the first appointment. This Physical Therapy Evaluation and Treatment Consent Form helps clinics collect injury history, conduct pain assessments, secure treatment consent, and obtain HIPAA-compliant authorization—all in one professional, organized form.

Why Paperform for Physical Therapy Intake

Paperform makes it easy for physical therapists and clinic administrators to create on-brand intake forms that patients can complete from any device before their appointment. The doc-style editor lets you add clear headings, helpful instructions, and conditional logic that shows relevant follow-up questions based on injury type or pain level.

Since physical therapy often involves insurance coordination and ongoing communication with referring physicians, this template includes fields for insurance details and medical records release authorization. You can integrate submissions directly into your practice management software, send automated confirmation emails, and keep everything organized in one place.

Built for Physical Therapy Workflows

This template is designed for:

• Physical therapy clinics conducting initial evaluations and treatment planning
• Sports medicine practices tracking injury history and functional limitations
• Rehabilitation centers coordinating care with referring providers
• Outpatient therapy practices managing insurance authorization and documentation

Automate Your Intake Process

Connect this form to your existing workflow using Stepper (stepper.io) to automatically route new patient information to your EMR system, notify therapists of upcoming evaluations, and trigger insurance verification tasks. You can also use conditional logic to show different consent language based on the patient's age or treatment type.

Paperform is SOC 2 Type II compliant and includes robust data security features, making it a trusted choice for healthcare practices handling sensitive patient information. While Paperform is not HIPAA compliant, it provides enterprise-grade security that over 500,000 teams worldwide rely on for their business-critical forms.