Forms/Payments

Patient Forms

Download any of the forms below as needed, by clicking on name.

1.) NOTICE OF PATIENT INFORMATION PRACTICES

2.) PATIENT INFORMATION ACKNOWLEDGEMENT FORM

3.) INTAKE FORM

4.) CONSENT FOR CARE

5.) DESIGNATED INDIVIDUALS AUTHORIZATION FORM
 

Payments

Make a payment on your Move With Me Physical Therapy Account.
Use your credit card, debit card, or PayPal.


Payment for Therapy


Questions about billing?
Please email our billing specialist, Carol Ann at cap@movewithmept.com.