Intake Form
Intake Form

FYZICAL Gainesville, FL looks forward to having you join our host of satisfied clients. Without you there can be no triumph. Because physical therapy without the client is intent without involvement. However inspired, it is like rain without water, only a hope. Because you Love Your Life, your independence, your day… we exist.

We look forward to welcoming you to our state-of-the-art facility and providing you the best physical therapy in Gainesville, FL. To schedule an appointment, please call us at (352) 240-1136.

Once you have made your initial appointment, you may pre-register online by completing the interactive forms below, or you may download and print the forms, fill them out and bring them with you to your first visit. Completing the forms prior to your visit will help speed up the registration process.


Patient Registration Form

Medical Intake Form

If you wish to Shadow or Volunteer with us, please fill out the following applicable forms.

Thank you!

The following forms are PDF files, which require the free Adobe Acrobat Reader program for viewing and printing.

Welcome Letter and Instruction

Policies, Procedures, and Volunteer Responsibilities

Adult Release of Liability

Parental Permission and Release of Liability (if under 18)

Confidentiality Agreement

HIPAA Summary

Dress Code

Student Contact Form (if volunteering or shadowing for school credit)

Emergency Contact

Evaluation of Experience (optional; only after all hours needed have been completed)

Time Sheet

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Leader in the health and wellness space, providing private practices with business systems, operational support, clinical education, and proprietary technology and protocols. FYZICAL® is actively changing the healthcare landscape by providing patients with wellness programs and clinical care in: Fall Prevention, Orthopedic and Vestibular Rehabilitation

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