Physical Therapy Intake Form

This form gathers medical history, current symptoms, injury details, and contact information. It’s perfect for physical therapy clinics, sports rehab centers, and wellness practices.

Why Use This Physical Therapy Intake Form?

Paper forms slow down your front desk and often lead to missing or hard-to-read data. This digital form keeps everything clean and easy to manage.
Patients can complete it before their visit, helping therapists prepare in advance and spend more time on actual care.
It improves patient experience, reduces admin work, and supports accurate treatment planning.

Smart Features That Make Intake Smooth

• Allow patients to upload referral letters or previous reports → Enable file uploads

• Collect digital consent or acknowledgments with signature fields → Enable electronic signature

• Use conditional logic to show follow-up questions based on injuries

• Export responses for EMR records or practitioner review

• Add branding to match your clinic’s look and feel

How to Use This Form

1. Click Use Template

2. Customize fields for patient info, symptoms, and insurance details

3. Add instructions or disclaimers based on your clinic’s policy

4. Share the form via email or website before the first appointment

5. View submissions in your dashboard and prepare ahead of time

Use this form to improve patient intake, reduce wait times, and help your team focus on care, not paperwork.