To help save time at your visit to Peak Physical Therapy, P.C.we suggest that you print out the applicable forms from the list below and bring the completed form with you.
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Please fill out the following forms for ALL patients:
If your injury was a result of a car accident please fill out the the following additional form:
New York Motor Vehicle No-Fault Insurance Law Assignment of Benefits
If your therapy is covered under:
THE EMPIRE PLAN (NYS GOVERNMENT PLAN)
ORANGE ULSTER SCHOOL DISTRICT
OXFORD HEALTH PLAN
UNITED HEALTHCARE POWER AUTHORITY
UNITED HEALTHCARE CH ENERGY OR CENTRAL HUDSON
Please fill out the attached forms as well:
