Forms

Prescription Form

Download the Bechtel Physical Therapy prescription form below.

Prescription Form

New/Cash Patients

If you are a new patient with private insurance (or paying in cash), please use the forms below.

Patient Info Summary PVT and WC

Patient Questionnaire

BPT Welcome – Private

HIPPA Disclosure

Worker's Comp Patients

If you are a new Worker’s Compensation patient, please use the forms below.

Patient Info Summary PVT and WC

Patient Questionnaire

BPT Welcome – WC

HIPPA Disclosure

Medicare Patients

If you are a new Medicare patient, please use the forms below.

Patient Info Summary – MC

Patient Questionnaire

BPT Welcome – Medicare

HIPPA Disclosure