Download new patient forms
Please print new patient forms below and complete them prior to your first visit to PhysioTherapy Professionals. These forms include demographic data, general patient history and description of payment policy that must be signed prior to treatment. If you have written documentation of past medical history or medication, we can copy this at the office for your convenience.
Should you wish to fax completed forms to the office prior to visit, the fax number is 217-546-3302.
Accepted Insurance Providers
- Blue Cross / Blue Shield PPO
- Health Alliance
- Healthlink HMO/PPO
- Medicare Part B
- Personal Care \ Coventry HMO and POS
- Liabillity/auto claims
- United Healthcare
- Worker’s Compensation
- Others may be accepted, contact us to find out
Private pay options are available if we do not accept your insurance. Please contact 217-546-3301 for more details.