Below you can find some helpful forms that you will need for your visit to O’Brien Physical Therapy & SOZO PT.
Please download, print, and completely fill out both forms and bring them with you on your first visit. If you have any questions, please give us a call. We are always happy to hear from our patients.
Patient Forms Required for First Visit
Medicare Forms (Please pick form associated with primary area of injury)
- DASH Form (Disabilities of Arms, Shoulders, Hands- Upper body)
- LEFS Form (Lower Extremity Functional Scale)
- Back Index
- Neck Index
For 3rd Party Personal Injury and Motor Vehicle Accident Patients:
Print and completely fill out forms and bring them to your initial appointment.
Massage only patients:
IN-NETWORK Insurance Plans:
(Although we will provide you the courtesy of verifying your insurance benefits, we strongly encourage you to verify the status with your insurance company)
We also accept Aetna, Humana, Health Net & BC/BS
We are IN NETWORK with the following plans at Chandler location ONLY: AETNA | HUMANA | HEALTHNET
Please contact us to verify coverage!
We also accept cash, check, Visa, Discover, or Mastercard
For billing statement questions or explanation of benefit (EOB) inquiries, please email firstname.lastname@example.org or contact us and our biller will return your message..
For more information on our services, in-stock product availability or if you have any questions, please feel free to contact us.