At Brevard Therapy & Physical Medicine, we value your time and we respect your privacy. Below, you will find our new patient forms, which you can download, fill out, and bring into our office at the time of your first visit. This will expedite the process for new patients. We have also provided links to our partner insurance provider web sites, where you can check your benefits and access other forms that may be required for reimbursement of medical claims.
Of course, if you have any questions or concerns, please feel free to call our office for assistance.
We want to do everything we can to eliminate any unnecessary stressors, which is why we include the option of completing your forms at home through our Patient Portal.
- Auto Accident Intake Form
- Health Insurance Patient Intake Form
- Minor Consent Form
- Records Request Form
Click here to install adobe reader if you have trouble downloading the forms.
- Beech Street
- Blue Cross/Blue Shield
- Health First
- United Health Care
- All automotive insurances
- Cash Plans Available
- And others (please call to inquire)