Information for New Patients

New Patient Forms

Please fill out the following form before your first appointment. If you have any questions, please call us: 586-5951 Downtown or 789-4165 in the Valley.

--Juneau Physical Therapy Patient Forms

Additional Forms

Please use these forms as directed by our office staff.

--DME Waiver Form

--Minor Patient Consent Form

Outcome Questionnaires

Please use these forms as directed by your Physical Therapist.

--Oswestry Low Back Pain Disability Questionnaire

--Neck Disability Index (NDI)

--The Lower Extremity Functional Scale (LEFS)

--QuickDASH

Cancellation / No-Show Policy

It is Juneau Physical Therapy policy that failure to attend two scheduled treatments sessions without providing 24-hour notice may jeopardize future appointments. Failure to attend physical therapy for two consecutive months without prior notice will result in automatic discharge.

Insurance Information and Billing.

Spectrum Medical Billing provides our billing service.

It is important to know your insurance coverage before coming in for an appointment. It is strongly suggested that you call your insurance provider prior to your first visit to verify your coverage and benefits under your plan. As a service to our clients, Juneau Physical Therapy will bill primary and secondary insurance carriers. At the time of your first appointment, please bring your insurance card.

We collect your co-pay and any outstanding deductibles at the time of service and bill insurance. Unless other arrangements have been made, you are responsible for paying in full at the time of service.
-Does your insurance provider cover PT/OT services? How many visits are you allowed per year?
-What is your deductible? Has your deductible been met for the year? What month does your deductible start over?
-What is your coverage? Does your insurance provider pick up 50%, 80%, 100%?

Juneau Physical Therapy is not a Medicare/Medicaid certified provider of medical equipment. It has been our experience that many secondary insurance carriers do not cover claims that Medicare has denied. Consequently, any heel lift, splint, orthotic or other item will be the patient’s responsibility. Juneau Physical Therapy is not responsible for changes in insurance coverage or their denial of services. It is the patient’s responsibility to confirm coverage and pay for what insurance does not cover.

Juneau Physical Therapy: Providing excellent physical therapy for the community we love.