Health History Form
For your convenience, the 'Health History Form' to the right has been provided here in order to expedite your initial visit. Please take the time to review and fill it out completely. This can be done electronically or printed and filled out. Completed forms can be emailed to [email protected]
(preferred) or brought to your first appointment. Insurance Benefits Worksheet
In order to help determine your physical therapy benefits, print the worksheet to the right which will guide you when contacting your insurance company.
Notice of Privacy Practices
If you would like to review and/or print our privacy policy, you can download the Notice of Privacy Practices.
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To fill out the 'Health History Form' electronically, click above, download the file to your computer and open in Adobe Reader. Under 'All Tools' you can select 'Fill & Sign', which will allow you to edit the document. You can then save it to your computer.
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Momentum Physical Therapy of New Paltz, PLLC. Copyright © 2013-2024. All Rights Reserved.
Disclaimer: The contents of this site is meant for educational purposes only and utilization of any of the material is a personal choice. Momentum Physical Therapy of New Paltz and Dr. Greg Cecere are not responsible for any harm or injury that may occur due to those choices. This site is by no means a substitute for a thorough evaluation and guidance by a licensed medical professional.
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