Physical Therapy Intake Form
Use this secure physical therapy intake form to collect key health and background information before a patient’s first visit. It makes it easy for patients to share what you need ahead of time, so you can focus on treatment, not paperwork. Send it by email or include it in a welcome packet on your website. Patient data is encrypted from the moment it’s submitted.
Form Template Preview
Submit this form to see what a completed submission looks like inside Hushmail:
Quick facts about this form
Who it's for:
- Physical therapists
- Physical therapy clinics
- Rehabilitation practices
Why use it:
- Show patients you take privacy seriously with secure, HIPAA-compliant forms
- Save time during the first appointment by collecting key information in advance
- Reduce paperwork and streamline your admin process
- Make a good impression with a seamless digital experience
Where to use it:
- In a welcome email after a patient books
- In a “New Patients” section on your website
- On your booking confirmation page
Pairs well with:
If your client skips a required field, the form will prompt them to fill it out. No more chasing after clients to fill out missing info.
Your client’s submission will live in Hushmail, where you can keep all submissions secure and organized in folders.
You can also download a PDF of the submission if you want to file a separate copy elsewhere, like your EHR.
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1.
You give us the form(s) you’re currently using in your practice.
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2.
You get a dedicated Customer Care rep to oversee the service and answer questions.
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3.
You end up with custom secure web forms that are easy for your clients to fill out.
