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Patient Forms

All patient forms can be found on this page. The forms can be filled in digitally or can be printed and filled in by hand.

Permission To Treat

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Before we treat you, we need your permission in written.

Cancellation Policy

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It Explains our rules for cancellations.

Patient Intake Form

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Patient’s personal and contact information.

Payment Policy

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Payment is due at the time of service.

Medical history and subjective report

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Brief collection of patient’s medical history and symptoms perception.

After scheduling your initial evaluation, please complete all forms and submit them to:

E-mail: Carolina@wholisticPT.co

Mail address: 1866 Harrier Avenue, Clermont, Florida 34711