Desert Physical Therapy

& Women's Health Center

Desert Physical Therapy & Women's Health Center
4545 E. Shea Blvd.
Suite 168
Phoenix, AZ 85028

ph: (602)264-3369
fax: (602)264-3368

Forms & Paperwork

To expedite the check-in upon your initial visit, please print and fill out the appropriate forms before you arrive at our office. If you are unsure which forms to fill out, please contact us. If you would prefer to fill out your paperwork in our office, please arrive at least 30 minutes before your scheduled appointment.

All Physical Therapy patients will need to fill out these General Forms

Click here to print out an Insurance Worksheet to help you ask the right questions about your physical therapy benefits.

Most insurance companies require a Prescription for Physical Therapy. If you need one, click here to print one out to take to your doctor.

Click here for our HIPAA Policy if you wish to review the specifics of our privacy practice.

Additional Paperwork: 

Loretta's patients - Choose one of the health history forms below:

  • For Women's Health conditions, please fill out this form
  • For Men's Health conditions, please fill out this form
  • For Lymphedema, please fill out this form

Diana's patients - Choose one of the health history forms below:

  • For Women's Health conditions, please fill out this form
  • For Musculoskeletal conditions, including dysfunction associated with Pregnancy, please fill out this form

Tara's patients - Choose one of the health history forms below:

  • For Pelvic Pain/Vulvar conditions, please use this form
  • For Pregnancy/Post-Partum, please use this form
  • For Urinary Incontinence, please use this form
  • For Orthopedic, Musculo-skeletal, and Other conditions, please use this form

Sara's patients - Choose one of the health history forms below:

  • For Incontinence conditions, please use this form
  • For Pediatric conditions, please use this form

 

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Desert Physical Therapy & Women's Health Center
4545 E. Shea Blvd.
Suite 168
Phoenix, AZ 85028

ph: (602)264-3369
fax: (602)264-3368