New Patient Information & Workman’s Compensation Forms
Prior to your first appointment, please open, print and complete these information forms. Bring them with you so that we can serve you more efficiently.
- New Patient Information Form - Used to verify insurance benefits
- Workman's Compensation Form - (Fill out if a Workman's Comp Injury ONLY)
- Medical History Form -ALL PATIENTS WHO WOULD LIKE TO SAVE SOME TIME DOING THEIR INTAKE PLEASE FILL THIS OUT PRIOR TO YOUR FIRST VISIT and then scan and email to email@example.com or fax to 830-249-7211!
- New Patient Referral Form - This form is for MD's, or for patient to take to MD for referral to BPTI
The above forms are pdf files and require Adobe Acrobat Reader to open and download. If you don't have Adobe Acrobat Reader installed on your computer, click on the above graphic to download this free player.
After completing these forms you may do one of the following:
- Email to firstname.lastname@example.org
- Fax them to 830.249.4698
- Mail them to:
FYZICAL Therapy & Balance Centers
C/O Benefits Coordinator
1411 South Main Street, Suite 102
Boerne, TX 78006