Patient Forms
Get help from Rivera Physical Therapy
Whether you have a new injury or a chronic pain, Rivera Physical Therapy can help you recover. Our staff can answer all your questions regarding online consultation, visitation, insurance coverage, direct access, and treatment procedures. Please print and fill the Patient Information Form and Privacy Acknowledgement to expedite the outpatient consultation process.
Help Us In Helping You!
Your personal details are always safe with us.
The form will collect medical information about the patient, diagnosis, emergency contact, and insurance plan.
The acknowledgement form assures that the patient has read and understood the privacy practices followed by Rivera.
The sheet details how the information you have provided will be disclosed and used as well as your individual rights.