Patient Forms/ Insurance

Save time by filling out your forms beforehand!

At iMotion Physical Therapy, we want to maximize your time with us. If you would like to save time on your first visit, please print the following patient documents below, fill them out, and bring them with you to your first appointment. Otherwise, allow extra time before your appointment to fill them out here.

At iMotion Physical Therapy, we want to maximize your time with us. Prior to your first visit, please either fill out the Online Patient Registration Forms or print and fill out the Printable Patient Registration Forms below and bring them to your first visit, along with your insurance information and photo ID.

Please choose one of the following options:

Online Patient Registration Forms

or

• Printable Patient Registration Forms

• 1

  Patient Registration Form

  Download And Print
• 2

  Financial Responsibility Form

  Download And Print
• 3

  Health Information Form

  Download And Print
• 4

  Authorization For Treatment Form

  Download And Print

Insurance Information

We gladly accept most the insurance plans. Please contact us at Fremont & Los Gatos, CA Centers to confirm your insurance. We are always adding new insurance plans.

As a courtesy to our patients, we will verify your health benefits prior to your arrival to determine if there will be a copay, deductible, or coinsurance for therapy services.

For those patients who do not have health insurance or those who have maxed out their benefits, we offer a private pay plan. Please contact iMotion Physical Therapy today at Fremont, Los Gatos & San Jose, CA Centers for more information on our fees for service and payment details.