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Professional Rehabilitation Services Physical Therapy Pawleys Island
Physical Therapy Surfside Beach
Get Out of Pain - Pain Relief Program
Joint Replacement
Vestibular Therapy
Balance Rehab
Golf Clinic
Spinal Decompression Program

Physical Myrtle Surfside Beach

Patient Forms

In order to expedite your visit, we have provided a convenient way to access, download, and print required forms prior to your first appointment. Please bring the following items and completed forms to your initial evaluation and arrive 15 minutes before your scheduled appointment:

  1. Up-to-date medical insurance card(s).
  2. Current prescription / referral from your doctor for physical therapy treatment (if needed).
  3. Picture I.D. (ex: Driver's License)
  4. Completed Registration Forms: Please select the appropriate categories below then download / print your forms.
  5. We urge you to call your insurance company about your physical therapy benefits before your appointment please use the insurance worksheet below when calling.

Our forms are PDF files. To download and print the forms, you'll need the free Adobe Acrobat Reader program.

All Physical Therapy Patients

*Please download the following forms below,
in addition to the PT forms above, which are applicable to you.*

Additional Forms for Medicare Patients
Additional Forms for United Healthcare Patients

Please download: Patient Health Questionnaire. (Complete bottom of the form only)

Then, download the form that pertains to the area we are treating:

Additional Forms for Primary Blue Cross/Blue Shield of SC Patients
Physical Therapy Referral
Please download one of the referrals below to take with you on your doctor's appointment.