Patient Forms & New Patient Registration
To streamline your first visit at our Edina or Minneapolis clinic, please complete the necessary patient forms in advance. Filling out these documents before your appointment saves time, allows us to review your history ahead of time, and ensures more time is dedicated to your evaluation and treatment. You may download, print, and complete the following forms at home, or you can request electronic versions via email. If you prefer, you can also complete all paperwork upon arrival.
Why Complete Forms Early?
- More Treatment Time: Avoid spending your session filling out paperwork.
- Better Preparation: Our therapists review your health history before your evaluation.
- Fewer Delays: Ensure all required consents and authorizations are in place.
- Enhanced Accuracy: You can gather records and details ahead of time.
Checklist for Your First Visit
Please bring the following items along with your completed forms:
- Photo identification (driver’s license or state ID)
- Insurance card(s) and referral if required
- Completed Patient Information Form
- Signed Acknowledgement of Receipt of Notice form
- Signed HIPAA Authorization
- Signed Medical Information Release
- Any relevant imaging reports or test results
- List of current medications and dosages
- Comfortable clothing for movement assessment
Form 1: Patient Information Form
This form gathers your personal details, medical history, and current health status so our therapists can develop a safe and effective plan. It includes:
- Demographics: Name, date of birth, address, phone, and email
- Emergency Contact: Name, relationship, phone number
- Primary Care Physician and specialist contacts
- Health History: Past surgeries, chronic conditions, allergies
- Medications: Prescription, over-the-counter, supplements
- Social History: Work, activities, exercise habits
- Functional Limitations: Activities that are difficult or painful
Download here: Patient Information PDF. Proper completion helps us tailor your physical therapy services to your specific needs.
Form 2: Acknowledgement of Receipt
Minnesota law requires that we provide and document your receipt of our Notice of Privacy Practices. This form confirms you have been informed of how we collect, use, and safeguard your personal health information. It covers:
- Your rights to access and amend your records
- Our commitment to confidentiality
- How to report any privacy concerns
Download here: Acknowledgement PDF. For details, see our Privacy Policy.
Form 3: HIPAA Authorization
This authorization allows us to share or obtain your medical records with other providers. It can be used to:
- Request diagnostic imaging (MRIs, X-rays) from hospitals or clinics
- Share treatment plans with your primary care or specialists
- Coordinate care for surgery, injections, or other interventions
Download here: HIPAA Authorization PDF. This helps us provide seamless, integrated care.
Form 4: Medical Information Release
When you have outside imaging or specialist reports, this release grants us permission to retrieve and review those documents. This can:
- Prevent duplicate tests
- Speed up treatment planning
- Ensure we have a full understanding of your condition
Download here: Medical Information Release PDF.
Digital Form Completion
If you prefer to complete forms online or via email, contact our front desk. We will send you secure, fillable PDF links or electronic forms that you can submit before your appointment. Email your request to staff@orthorehabpt.com or call 952.922.0330.
Tips for Accurate Form Completion
- Use black or blue ink when printing forms.
- Answer all questions thoroughly; incomplete sections may delay care.
- If something does not apply, write N/A rather than leaving it blank.
- Review medication names and dosages carefully.
- Bring any lab results, imaging reports, or referral letters you have.
Clinic Resources
To prepare further for your visit, explore these resources:
- New Patient Information – What to expect on your first visit
- Manual Therapy Services – Techniques we use to relieve pain and improve mobility
- Functional Testing – How we assess movement patterns and strength
- Top 10 Physical Therapy Exercises – Exercises you can begin at home
Frequently Asked Questions
- Can I complete forms at the clinic?
- Yes. We have printed forms and tablets available for your convenience. Completing them in advance speeds up check-in.
- What if I cannot print at home?
- Call us at 952.922.0330 and we will mail you paper copies or email a fillable PDF.
- Are my forms secure?
- Yes. All personal and medical information is handled in compliance with HIPAA regulations. Electronic submissions use encrypted email or a secure portal.
- What if I need help understanding the forms?
- Our front desk and clinical staff can clarify any questions when you arrive or over the phone.
Next Steps
Completing your forms ahead of time ensures your therapist can focus on assessment and treatment during your first appointment. Download and complete your patient forms now:
