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Chicago Physical Therapists
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Chicago Physical Therapists
Home
About
Our team
Our clinic
Services offered
Testimonials
Conditions we treat
Overview
Women's health
Orthopedic conditions
Persistent pain
Lymphedema
Resources
Therapy resources
Products we love
Businesses we love
Make a payment
New patients
Book an appointment
FAQ
Rates and policies
New patient forms
CPT Blog
Contact us
Book an appointment
Home
Folder: About
Back
Our team
Our clinic
Services offered
Testimonials
Folder: Conditions we treat
Back
Overview
Women's health
Orthopedic conditions
Persistent pain
Lymphedema
Folder: Resources
Back
Therapy resources
Products we love
Businesses we love
Make a payment
Folder: New patients
Back
Book an appointment
FAQ
Rates and policies
New patient forms
CPT Blog
Contact us
Book an appointment

New patient forms

 
 

Once you schedule your first visit online or via phone, an email or text will be sent to fill out forms and medical information.

Intake Forms (all new patients, both in-network and out-of-network)

Out-of-Network Billing Agreement

Telemed Consent Form (if you have a telemedicine appointment)

Postpartum Intake Form (if you have been pregnant or had a baby within the last year)

Chicago Physical Therapists

4721 N Clark St, #1S

Chicago, IL 60640

Phone 773.770.3682

FAX 773.305.7767

Quick links

Conditions We Treat
Services We Offer
Our Team

Careers: Pelvic and Ortho PT Position

Careers: Hypermobility, EDS, POTS PT Position

Billing Questions

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