Rehabilitation Registration Forms

Thank you for choosing to attend Outpatient Therapy. 

In order to make the registration process quick and easy, we recommend that you print off the below forms and fill them out before your evaluation and bring them on the day of your evaluation.  If you have not yet scheduled your evaluation then please call 452-8104 for an appointment or more information.

Adult Forms:

• Registration form
• Patient information form
• Guidelines for Outpatient Therapy - Oleander Rehab
• Guidelines for Outpatient Therapy - Indepence Rehab

Additional forms include:

• Activity Measure (AM-PAC) - to be completed by individuals with Medicare.
• Accident Information form - to be completed if your therapy is the result of an accident and you have Medicare.

Pediatric Forms:

• Patient information form for children receiving therapy
• Guidelines for Outpatient Therapy