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

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

*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 - UHC / AETNA / NYSHIP (EMPIRE PLAN) Patients

Additional Forms for Primary Blue Cross/Blue Shield of SC Patients

Physical Therapy Referral

Please download the referral below to take with you on your doctor's appointment.

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Our Locations

From Pawleys Island to Myrtle Beach and Conway, Professional Rehabilitation Services provides Physical Therapy Services for the Georgetown, Pawleys Island, Surfside Beach, Murrells Inlet, Socastee, Myrtle Beach, Conway and Little River South Carolina communities.