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Northeast Kingdom Physical Therapy

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New Patient Info

New Patient Forms

Once you have scheduled your initial appointment, either personally or through your physicians office, please print out the following patient forms, fill them out to the best you can and bring them with you, along with your insurance card(s) and/or information. If your injury is a direct result of a workers compensation claim or motor vehicle accident, please be sure to bring your claim numbers, adjustors name and phone number, lawyers info etc. to our office. This will help in getting you in to see the therapist in a timely manner to address your care properly.

Patient Forms (files require the free Adobe Acrobat Reader).  For best results, use Internet Explorer or Google Chrome browsers:

  • Authorization Form *
  • Patient Information *
  • Patient Intake Form (2 pages) *

* These Patient Forms may be filled out online, printed, saved and emailed to nekpt@hotmail.com

Insurance

Some insurance companies (or self-pay patients) do not require a referral. However, most insurances do require a referral from your physician. If you are unsure, please call your insurance company directly for more information. You can call us directly or have your physicians office call to schedule your first visit which is called an Initial Evaluation. Patient forms are needed to be filled out by you and brought with you for the Initial Evaluation (IE). This appointment last approximately one hour. All subsequent visits for Therapy lasts approximately 30 minutes. During your IE, your Therapist will evaluate you and determine a plan of care which will include what types of treatment and modalities will be used. Before you leave the office, appointments will be made for your follow-up care and presented to you on paper as reference. All attempts to accommodate your schedule will be adhered to, and in case you need to cancel, please call within 24 hours to notify us of the change.

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Contact Us

Newport
235 Lakemont Road
Newport, VT 05855
Phone: 802-334-8558
Fax: 802-334-8559

Business Hours
Newport:
Mon- Fri: 5am- 9pm
Sat: 8am- Noon

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Location

235 Lakemont Road
Newport, VT 05855
Phone: 802-334-8558
Fax: 802-334-8559

Business Hours

Hours
Mon-Fri: 5am-7pm
Sat: 8am- Noon

Contact Us

E-mail Us
American Physical Therapy Association

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