NEW PATIENT FORMS

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Intake Form

In order to maximize your time with the physical therapist, we suggest that you download and print the appropriate forms before your appointment and bring them with you to your session.

Referrals from your physician can be faxed to us:

Fax 833-847-1778

Please fill out the form below in advance of your session.

NEW PATIENT INTAKE FORM

© 2020 TheraPilates® Physical Therapy & Dr. Sherri Betz

609 Auburn Avenue Monroe, LA 71201

Tel: 318-450-1747

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Physical Therapy, Pilates Private Sessions and Group Exercise

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