top of page

Covering the Care We Provide

Forms

Feel free to print the PT Intake and the Office Intake forms, fill them out, and bring them with you to your first visit. All the following forms can be provided by the receptionist at Summit Physical Therapy, Inc. and may be completed the day of your evaluation if you would prefer. You may review our Patient Bill of Rights in this section as well.

New Patient Packet

Individual Forms

Patient Office Intake Form

Patient PT Intake Form

Patient Bill of Rights

Notice of Privacy Practices

Notice of Privacy Practice Acknowledgement

No Show Policy

Media Release

​

PHI Release 

Request an Appointment

Thanks! Message sent.

bottom of page