Rehabilitation Services

Please note that if you have a current prescription from your doctor for physical therapy, occupational therapy, or speech therapy already, you can proceed with this form. If you are a new rehabilitation patient and you have not received a prescription from your physician, you will need to do that prior to filling out this form. In addition, new patients are encouraged to come in for an in-person evaluation and then, if appropriate, the therapist can make telehealth part of your treatment plan to limit the amount of follow up visits needed in the clinic.


Appointment Request Form


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  • Phone Number