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Physical Therapy Consent Form

Asks about referring physician, primary condition or diagnosis, and treatment techniques authorized. Built for onboarding new patients for outpatient physical therapy programs.

Questions
11
Pages
2
Time
about 3 min

Includes

  • E-signature
  • Consent agreement
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Your practice

Physical Therapy Consent Form

Page 1 of 2 · Your information

Live preview. Tap through it like a patient.

Who it is for

  • Onboarding new patients for outpatient physical therapy programs
  • Documenting consent for manual therapy and therapeutic modalities
  • Recording patient commitment to home exercise and attendance expectations
  • Meeting informed consent requirements for sports rehabilitation services

Formisoft for Mental HealthFormisoft for Physical Therapy

What's inside

Before you publish: Add your practice-approved consent wording before publishing.

Page 1 · Your information

  1. Patient Full NameText · Required
  2. Date of BirthDate
  3. Referring PhysicianText
  4. Primary Condition or DiagnosisText
  5. Treatment Techniques AuthorizedLong Text

Page 2 · Additional details

  1. Home Exercise Program CommitmentLong Text
  2. Modalities Consent (e.g., E-Stim, Ultrasound)Consent Agreement
  3. Consent to TreatmentConsent Agreement
  4. Patient SignatureE-Signature
  5. Date of ConsentDate

From form to a ready patient

  1. The Formisoft form builder with editable questions and required toggles

    01

    Make it yours

    Reword, reorder, or add to the Physical Therapy Consent Form, and add your logo.

  2. A patient filling out a Formisoft form on a phone

    02

    Patients finish it at home

    A secure link by text or email, filled out on their phone before the visit. No app.

  3. The Formisoft dashboard showing how many of today's patients are ready

    03

    Your team sees who is ready

    Each visit shows as ready once its forms are in. Answers land on the patient record.

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Questions

Responses are encrypted, only your team can see them, and a BAA is included.

Yes. You can add, remove, reorder, or reword any of the 11 fields. You can also add conditional logic, new pages, file uploads, e-signatures, and payment fields.

Yes. Attach the form to a visit type and every patient who books gets it right away, with a reminder before the visit if it is not done. Your calendar shows which visits are ready.

Send it before the visit, so patients arrive ready.

Book a short call and we will set up the Physical Therapy Consent Form for your practice, ready to send before the next visit.

BAA included · We set up your front desk

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