New Patient Forms

In an effort to expedite the check-in process on your first visit, we encourage you to complete our New Patient Forms ahead of time.  You may access the forms below, complete them electronically, then either print them or email them back to us at scheduling@presidiosport.com.

If you’ve completed paperwork ahead of time, please plan to arrive 5-10 minutes prior to your appointment time so our Client Service Specialists can review your insurance benefits, our office policy, and complete your chart set-up prior to beginning treatment with your therapist.  Please note that depending on your insurance plan, your insurance company may require additional paperwork which we will have you complete in the office.

Along with your completed paperwork, please bring your insurance card and your doctor’s referral, if you have one, to your first appointment.

New Patient Forms can be found here >> New Patient Forms

  1. Patient Intake Form: fill in completely, sign and date
  2. Medical History Form: fill in completely, sign and date
  3. Office Policy: review, initial sections, and complete payment information
  4. HIPAA Notification Form: either sign the Acknowledgement OR Waiver section

Medicare New Patient Forms can be found here >> Medicare New Patient Forms

  1. Patient Intake Form: fill in completely, sign and date
  2. Medical History Form: fill in completely, sign and date bottom
  3. Medication List: fill in all medications you are taking
  4. Office Policy: review, initial sections, and complete payment information
  5. HIPAA Notification Form: either sign the Acknowledgement OR Waiver section

HIPAA Privacy Notice
As of April 14, 2003 it is required for all patients to understand their rights under the Health Insurance Portability and Accountability Act of 1996.  To comply with federal regulations, you may view our HIPAA Privacy Notice here or in our clinic.

The New Patient Forms and HIPAA Privacy Notice require Adobe Reader.  You may download it here for free if needed.

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