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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 download, print and fill out the form below in advance of your session.   Please Email to info(at)therapilates.comText to 318-450-1747 or Fax 833-847-1778 the form to us. and we will call you to book your physical therapy session.

© 2020 TheraPilates® Physical Therapy & Dr. Sherri Betz

609 Auburn Avenue Monroe, LA 71201

Tel: 318-450-1747

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