Physical Therapy Evaluation Appointment Form

Streamline Your Physical Therapy Intake with Paperform

Whether you're a physical therapy clinic, sports medicine practice, or rehabilitation center, getting new patients scheduled and prepared for their first evaluation can involve a lot of back-and-forth. This Physical Therapy Evaluation Appointment Form brings everything together in one professional, easy-to-use experience.

What This Template Does

This form is designed specifically for healthcare providers who need to collect comprehensive patient information before an initial physical therapy evaluation. It captures injury or condition details, physician referral documentation, insurance verification, scheduling preferences, and location selection—all while maintaining a clean, reassuring experience that reflects the quality of care you provide.

Instead of juggling phone calls, email attachments, and paper forms, your patients can complete everything online at their convenience. The form uses conditional logic to show relevant questions based on their situation (like additional fields for workers' compensation cases or auto accidents), and file upload fields make it simple to submit referrals and insurance cards directly.

Perfect For

• Physical therapy and rehabilitation clinics
• Sports medicine practices
• Orthopedic therapy centers
• Hospital-based PT departments
• Mobile physical therapy services
• Multi-location therapy practices

How Paperform Elevates Your Patient Experience

With Paperform's appointment scheduling capabilities, patients can select available time slots that sync with your calendar in real-time—no double bookings, no phone tag. The form can be embedded on your website, shared via email, or sent through patient portals, and it looks professional on any device.

Because Paperform is SOC 2 Type II compliant and takes data security seriously, you can confidently collect sensitive patient information knowing it's protected. While this template is not HIPAA compliant out of the box, it provides a strong foundation for patient intake and scheduling workflows.

Automate Your Follow-Up with Stepper

Once a patient submits their evaluation request, you can use Stepper to automatically route their information to the right team members, send confirmation emails with intake forms, update your practice management system, and trigger reminders before their appointment. This keeps your administrative team focused on care, not data entry.

Get Started in Minutes

This template is ready to customize with your clinic's branding, locations, and availability. Add your logo, adjust the color scheme to match your website, and configure the scheduling calendar to reflect your actual appointment slots. Your first patients can start booking within minutes.