{"id":4826,"date":"2022-09-03T10:35:46","date_gmt":"2022-09-03T10:35:46","guid":{"rendered":"https:\/\/divinespinept.com\/newtestsite\/?page_id=4826"},"modified":"2023-09-24T01:38:07","modified_gmt":"2023-09-24T01:38:07","slug":"patient-info-forms","status":"publish","type":"page","link":"https:\/\/divinespinept.com\/newtestsite\/services\/patient-info-forms\/","title":{"rendered":"Patient Info \/ Forms"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"4826\" class=\"elementor elementor-4826\">\n\t\t\t\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-1b1a21e elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"1b1a21e\" data-element_type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-f69e22a\" data-id=\"f69e22a\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t\t<section class=\"elementor-section elementor-inner-section elementor-element elementor-element-f2de5e3 elementor-section-content-middle elementor-reverse-mobile elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"f2de5e3\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-no\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-inner-column elementor-element elementor-element-33f9786 elementor-invisible\" data-id=\"33f9786\" data-element_type=\"column\" data-settings=\"{&quot;animation&quot;:&quot;fadeInLeft&quot;}\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-element elementor-element-4364b70 elementor-widget elementor-widget-image\" data-id=\"4364b70\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<style>\/*! elementor - v3.7.8 - 02-10-2022 *\/\n.elementor-widget-image{text-align:center}.elementor-widget-image a{display:inline-block}.elementor-widget-image a img[src$=\".svg\"]{width:48px}.elementor-widget-image img{vertical-align:middle;display:inline-block}<\/style>\t\t\t\t\t\t\t\t\t\t\t\t<img width=\"182\" height=\"58\" src=\"https:\/\/mail.divinespinept.com\/wp-content\/uploads\/2022\/05\/icons-star.png\" class=\"attachment-large size-large\" alt=\"star icon\" loading=\"lazy\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-b6ca5b8 elementor-widget elementor-widget-heading\" data-id=\"b6ca5b8\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<style>\/*! elementor - v3.7.8 - 02-10-2022 *\/\n.elementor-heading-title{padding:0;margin:0;line-height:1}.elementor-widget-heading .elementor-heading-title[class*=elementor-size-]>a{color:inherit;font-size:inherit;line-height:inherit}.elementor-widget-heading .elementor-heading-title.elementor-size-small{font-size:15px}.elementor-widget-heading .elementor-heading-title.elementor-size-medium{font-size:19px}.elementor-widget-heading .elementor-heading-title.elementor-size-large{font-size:29px}.elementor-widget-heading .elementor-heading-title.elementor-size-xl{font-size:39px}.elementor-widget-heading .elementor-heading-title.elementor-size-xxl{font-size:59px}<\/style><h1 class=\"elementor-heading-title elementor-size-default\">Welcome to Divine Spine Physical Therapy<\/h1>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-979c1cc elementor-widget elementor-widget-text-editor\" data-id=\"979c1cc\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<style>\/*! elementor - v3.7.8 - 02-10-2022 *\/\n.elementor-widget-text-editor.elementor-drop-cap-view-stacked .elementor-drop-cap{background-color:#818a91;color:#fff}.elementor-widget-text-editor.elementor-drop-cap-view-framed .elementor-drop-cap{color:#818a91;border:3px solid;background-color:transparent}.elementor-widget-text-editor:not(.elementor-drop-cap-view-default) .elementor-drop-cap{margin-top:8px}.elementor-widget-text-editor:not(.elementor-drop-cap-view-default) .elementor-drop-cap-letter{width:1em;height:1em}.elementor-widget-text-editor .elementor-drop-cap{float:left;text-align:center;line-height:1;font-size:50px}.elementor-widget-text-editor .elementor-drop-cap-letter{display:inline-block}<\/style>\t\t\t\tWe are here to help you enjoy your life, pain-free! To make a convenient appointment, simply call us today 908-444-6055. Our practice is dedicated to helping our patients identify the cause of their pain and creating a custom treatment program that will allow them to return to normal activities pain-free.\n\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-inner-column elementor-element elementor-element-c4b98a3\" data-id=\"c4b98a3\" data-element_type=\"column\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-element elementor-element-d46b560 elementor-widget elementor-widget-spacer\" data-id=\"d46b560\" data-element_type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<style>\/*! elementor - v3.7.8 - 02-10-2022 *\/\n.elementor-column .elementor-spacer-inner{height:var(--spacer-size)}.e-container{--container-widget-width:100%}.e-container>.elementor-widget-spacer{width:var(--container-widget-width,var(--spacer-size));-ms-flex-item-align:stretch;align-self:stretch;-ms-flex-negative:0;flex-shrink:0}.e-container>.elementor-widget-spacer>.elementor-widget-container,.e-container>.elementor-widget-spacer>.elementor-widget-container>.elementor-spacer{height:100%}.e-container>.elementor-widget-spacer>.elementor-widget-container>.elementor-spacer>.elementor-spacer-inner{height:var(--container-widget-height,var(--spacer-size))}<\/style>\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-acd546a elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"acd546a\" data-element_type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-d8d8494\" data-id=\"d8d8494\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t\t<section class=\"elementor-section elementor-inner-section elementor-element elementor-element-2dd626b elementor-section-content-middle elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"2dd626b\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-no\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-inner-column elementor-element elementor-element-320cef8\" data-id=\"320cef8\" data-element_type=\"column\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-element elementor-element-c86ec5a elementor-widget elementor-widget-spacer\" data-id=\"c86ec5a\" data-element_type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-inner-column elementor-element elementor-element-beb27e8 elementor-invisible\" data-id=\"beb27e8\" data-element_type=\"column\" data-settings=\"{&quot;animation&quot;:&quot;fadeInRight&quot;}\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-element elementor-element-2528fca elementor-widget elementor-widget-image\" data-id=\"2528fca\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img width=\"182\" height=\"58\" src=\"https:\/\/mail.divinespinept.com\/wp-content\/uploads\/2022\/05\/icons-star.png\" class=\"attachment-large size-large\" alt=\"star icon\" loading=\"lazy\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-5de23f8 elementor-widget elementor-widget-heading\" data-id=\"5de23f8\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h4 class=\"elementor-heading-title elementor-size-default\">Patient Forms<\/h4>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-5c61e24 elementor-widget elementor-widget-text-editor\" data-id=\"5c61e24\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p>At\u00a0Divine Spine Physical Therapy, we want to maximize your time with us. Prior to your first visit, please follow the Intake Form link below and submit that online. Then print and fill out the New Patient Registration Form below, and\u00a0bring it\u00a0with you to your first visit along with your insurance information and photo ID.<\/p><ul><li>Patient Intake Form<\/li><li>Patient Agreement Form<\/li><li>Medication List<\/li><li>Medical Release Form<\/li><\/ul>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-69ba07c elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"69ba07c\" data-element_type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-2ab0d47\" data-id=\"2ab0d47\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-element elementor-element-e19048b elementor-widget elementor-widget-text-editor\" data-id=\"e19048b\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"mid\">\n<div id=\"post-1392\" class=\"post cf\">\n<div class=\"entry\">\n<h3>Before Your First Visit<\/h3>\n<ul>\n<li>Make a list of questions that you have to discuss on your first visit.<\/li>\n<li>List signs and symptoms that can be of importance to the therapist.<\/li>\n<li>Have in writing key past medical history, previous treatments, current medications, and other important information.<\/li>\n<li>Please call our office to verify your insurance benefits.<\/li>\n<li><strong>Arrive 15 minutes early<\/strong>&nbsp;for your first appointment.<\/li>\n<li>Bring with you a copy of your insurance card and a photo ID.<\/li>\n<\/ul>\n<h3>What to Expect on Your First Visit<\/h3>\n<ul>\n<li>You will register with our friendly front office staff. They will help you navigate the insurance process and treatment program so you can focus on your recovery.<\/li>\n<li>You will meet with your physical therapist for the initial evaluation.<\/li>\n<li>During the evaluation your therapist will ask questions about your medical history, current pain, or injury. Open communication helps us understand your problem.<\/li>\n<li>Your movement, strength, coordination, and much more will be evaluated. Our purpose is to help you, so please ensure you communicate to your therapist if anything is hurting or bothering you during the examination.<\/li>\n<li>Your therapist will recommend and prepare a course of treatments to ensure the quickest recovery and the best results. Your therapist will discuss the recommendations with you.<\/li>\n<li>There will be some treatments performed the first day to get you started on your road to recovery. However, during the next visit you will get into the full swing of your treatment plan.<\/li>\n<li>You will schedule your series of visits with the front desk. The amount of therapy needed will be discussed with you, depending on the recommendations of your therapist. We offer many convenient appointment times, however prime times can become busy, so it is best to book ahead as much as possible.<\/li>\n<li>Your therapist will write up their findings and treatment plan to submit to your referring physician or other medical professional who you choose.<\/li>\n<li>If you have any questions at anytime, please don\u2019t hesitate to call. We want to ensure your satisfaction and full recovery.<\/li>\n<\/ul>\n<h2>Health Insurance<\/h2>\n<p>We gladly accept most&nbsp;insurance plans. Please call us to verify your insurance as we are always adding new insurance plans.<\/p>\n<p>As a courtesy to our patients, we will verify your health benefits&nbsp;prior to your arrival to determine if there will be a copay, deductible, or coinsurance for therapy services. For those patients who do not have health insurance&nbsp;or those who have maxed out their benefits, we offer a private pay plan. &nbsp;Please&nbsp;<strong>contact us<\/strong>&nbsp;today for more information on our fees for service and payment details.<span style=\"font-size: inherit; text-align: inherit; color: var( --e-global-color-text ); background-color: var( --e-global-color-blocksy_palette_8 ); font-family: var(--fontFamily); font-style: var(--fontStyle, inherit); letter-spacing: var(--letterSpacing); text-transform: var(--textTransform);\">&nbsp;<\/span><\/p><\/div><\/div><\/div>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Welcome to Divine Spine Physical Therapy We are here to help you enjoy your life, pain-free! To make a convenient appointment, simply call us today 908-444-6055. Our practice is dedicated to helping our patients identify the cause of their pain and creating a custom treatment program that will allow them to return to normal activities pain-free. Patient Forms At\u00a0Divine Spine Physical Therapy, we want to maximize your time with us. Prior to your first visit, please follow the Intake Form link below and submit that online. Then print and fill out the New Patient Registration Form below, and\u00a0bring it\u00a0with you\u2026<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":4668,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"elementor_header_footer","meta":{"nf_dc_page":"","inline_featured_image":false},"blocksy_meta":{"styles_descriptor":{"styles":{"desktop":"","tablet":"","mobile":""},"google_fonts":[],"version":5}},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v19.8 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Patient Forms | Divine Spine Physical Therapy Monroe NJ<\/title>\n<meta name=\"description\" content=\"Click here to download &amp; fill out the new patient forms &amp; make your first visit easy &amp; time-saving. Call Divine Spine to verify your insurance policy in Monroe\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/divinespinept.com\/services\/patient-info-forms\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Patient Forms | Divine Spine Physical Therapy Monroe NJ\" \/>\n<meta property=\"og:description\" content=\"Click here to download &amp; fill out the new patient forms &amp; make your first visit easy &amp; time-saving. 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