Demo Login

9 pieces of information to include on your physical therapy intake forms

Physical therapy intake forms are the documentation that new patients fill out before each session. These give a clinic pertinent information on a patient’s background and medical history. There are many kinds of information that may be filled out on a physical therapy practice’s intake form. However, intake forms aren’t just about filling out information. They are also one of the initial ways that your practice can start building a good rapport with a new patient. In addition, creating, sending and managing intake forms are all tasks that can all be made easier with the right electronic medical records (EMR) system.

What are some examples of information to include on your physical therapy intake forms?

  • Basic patient information — One of the most important types of information to get from your patients on their physical therapy intake forms is their basic information. This includes any identifying information like their name, address, birthdate and sex. This is key for the identification of each patient. It’s a basic method of distinguishing one patient from the next. Not only that, but it can help give your practice a clearer idea of who your clientele is, which you’ll want to know.
  • Why they’re visiting your practice that day — Another piece of information you should be sure to include on your physical therapy patient intake form is the reason for their visit. Getting this information before each session can help make the most out of each session. It cuts down on the time needed to discuss what a patient thinks may be ailing them and their description of their symptoms. It’s important to offer a few different questions to your patients that intentionally target areas of interest like, “Where do you feel your pain?” and “On a scale from 1 to 10 with 10 being the worst, how would you rate your pain?”
  • Medical history — Medical history is very important to ask for on a physical therapy intake form. It informs clinics on the conditions, medications or past injuries a patient may have. It could give your practice’s clinicians a hint as to why a patient may be experiencing a certain condition. It can also help prevent any health issues or accidents during the session.
  • Billing policy — It’s important to make sure your patients know what to expect by the bill or your billing policy that applies after they attend their physical therapy sessions. 
  • Insurance information — Most people have health insurance; it’s important to make sure that you collect insurance information for each of your patients. It’s also important to confirm that your practice accepts their insurance before each session. 
  • Consent forms, if necessary — Some services during physical therapy sessions may need your patients’ consent. If a patient is visiting your practice to receive such a service, it’s imperative that you get their written consent. This can be filled out via a consent form attached to the physical therapy intake form.
  • Who referred your physical therapy practice to the patient — This information is more for you to understand how your marketing is performing. However, you could benefit from asking for this information from your patients on the patient intake forms.
  • Patient acknowledgment of HIPAA — It’s imperative that you include a form asking your patients to acknowledge HIPAA before providing them with any services.
  • HIPAA compliant e-signatures — You can choose to have your patients sign their physical therapy intake forms on physical paper or you can do it electronically! Fortunately, documentation can be made seamless when using electronic forms, and getting your patients to sign can be made super simple. Electronic signatures are easy and HIPAA compliant.

One more thing to include, which is completely optional, is a notes section. You can leave a space on your forms for your patients to write out anything else they’d like to make their physical therapy care providers aware of before their session.

Your practice can build a more effective, rapport-building patient intake form process with AgileEMR

AgileEMR is a comprehensive solution that helps boost physical therapy practice management. Our system is unique in that it was created using the input from physical therapists. As a result, it’s truly designed to address the specific challenges that PT practices face, and this includes creating patient intake forms that help you build a positive rapport with your patients, are easy to send to new patients, and are easier to manage and integrate into patients’ files.

For instance, AgileEMR has an extensive template library. The customized templates we’ve created allow you to more easily craft customized patient intake forms that help you get the patient information you need. The customization our platform provides also allows your practice to word instructions and questions in a way that helps you continue the process of building a good rapport with new patients.

Since we launched AgileEMR in 2013, our software solution has helped our partners manage the patient experience from intake forms, to future appointments and more for over 1 million PT cases. 

Find out how AgileEMR can assist your PT practice’s team

We feel certain that our AgileEMR system can streamline the operations of your outpatient physical therapy and rehabilitation practice. Yet we understand that every practice needs to research all its options when it comes to bringing in an EMR and practice management system. That’s why our team is standing by to help you learn more about what your practice can accomplish with AgileEMR. Even better, your team can meet with one of our experts to view a demo that will walk you through the capabilities and benefits of using our unique system.

Contact our team today for more information about AgileEMR or to schedule your demo to see how it can help streamline your practice’s operations.

Learn More About
Physical therapy operations