Physical Therapy Forms

pic_evaluation-formsAll patients should fill out the following forms:

Additionally, if you are experiencing pain in any specific area, please download and fill out the respective form(s).

Schedule an appointment today by email or phone:
(703) 329-0181

Before starting physical therapy, it is important for us to know your medical history, previous injuries and current pain. Please fill out the physical therapy forms below and bring them with you to your first physical therapy appointment. During your first visit to our office, you will undergo a PT evaluation, where we perform a comprehensive assessment of the following:

  • Complete Review of Systems
  • Active and Passive Joint Range of Motion
  • Accessory Motion of Joints
  • Strength
  • Overall Flexibility
  • Vital Signs
  • Balance
  • Posture
  • General Health
  • Gait (walking mechanics)
  • Soft tissue mobility
  • Functional movements: the way in which bones, muscles, ligaments and joints work together

SPARK Physiotherapy participates with a variety of insurance plans but some of our services are not covered by insurance. All payments are due at the time of service. Please check with your insurance provider regarding your out of network benefits.  SPARK is NOT a Medicare participating provider.  We cannot bill Medicare on your behalf.  You are entitled to receive covered physical therapy services from a participating provider.  

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