Forms
In an effort to expedite your first visit, the intake forms are available online for you to fill out prior to your appointment. Depending on your insurance, there may be supplemental forms in addition to the standard intake form. These forms provide the additional information required by your insurance company. If you would like to request your physician to send a referral for you to come to Wahiawa Physical Therapy LLC, please download the Physical Therapy Treatment Plan and have him fill it out.
Physical therapy services in Hawaii require a doctors prescription after the first visit. If you are not sure whether or not your condition could benefit from physical therapy services, you may schedule your first visit directly with us, without having to see your doctor first. We will take your through a comprehensive initial evaluation and determine whether you simply require some education and a simple home exercise program that you may continue at home, or whether your condition may need follow up physical therapy visit(s), in which case you will need to get a prescription from your physician. In either case, we will be happy to give you guidance toward symptom relief. If you would like to see your physician before our services, click here to download a prescription form.
📄 Physical Therapy Treatment Plan (a.k.a. Prescription)
This is your prescription for physical therapy treatment. It needs to be filled out and signed by your physician. Physicians can print this form, or prospective patients can print this form and take it to your physician to fill out. Adobe Flash Player is needed to print
Patient Intake Form
Once you have a PT appointment, the office staff will email the patient intake form to be filled out prior to your appointment.
Medical History Form
Once you have a PT appointment, the office staff will email the medical history form to be filled out prior to your appointment.