Resources
New Patients will need to bring in the following on their first visit to Beachside Physical Therapy:
● New Patient Info Form (below)
● Patient Medical History Form (below)
● Determination of Payer Form (below)
● HIPAA Consent Form (below)
● Cancellation Policy Notice (below)
● Driver License or Photo ID
● Insurance Card
● OPTIMAL Forms (for Medicare patients ONLY)
The following forms are in PDF format. You must have Adobe Acrobat Reader to view/print these forms. You can download the program HERE.
Patient Information Forms (5 pages)
OPTIMAL Paperwork - All Medicare patients should fill out these 3 pages. The first page is a demographics page. The second page should be filled out according to the amount of DIFFICULTY you have with the listed activities. The third page should be filled out according to the CONFIDENCE you have in doing those activities. If you have any questions about these forms, feel free to bring them in to your evaluation
Patients, please feel free to download this form and have your doctor fill it out for you.
Doctors, please feel free to download a copy of our referral form for your records. If you would like a referral pad, please contact SaRah at 321-777-4033.
