Forms
  Please click on the links below to download the appropriate forms.
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Back To Top New Patient Forms
Please download this to take to your physician if you need a prescription for physical therapy

New Medicare Patient Forms
Please download this to take to your physician if you need a prescription for physical therapy.

MTI Privacy Practices (HIPAA)
This is our policy of how we protect your private information and medical records. This is a Federal Law that requires all health care practices to conform with.

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Medical Records Release
This is used when you ant us to send your records to yourself or another professional (i.e. attorney, physician, etc.)

MTI Lein
A lein may be required when there is a third party involved in the billing process (you get in an accident and the other person's insurance is going to pay). This protects us from that insurance company if they decide to default on the reimbursement of care. Usually this is only needed when/if reimbursement is dispersed from a settlement.

MTI Prescription
Please download this to take to your physician if you need a prescription for physical therapy.

Forms
Manual Therapy - Orthopedics - Sports Therapy - Spine © 2005 MTI Physical Therapy