For all new patients please fill out the following form in your preferred format, prior to your first appointment at Proactive Physical Therapy.

New Patients Registration Form


New Patients Registration Form

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  • Our goal is to make the process of paying for your physical therapy as easy and painless for you as possible. We have found that the best way for us to do that is to clarify your liability and establish your means of payment at the outset, and to help you to stay current on your account by collecting your share of payment for each visit at the time of service. For your convenience we accept cash, checks, VISA, Mastercard, American Express, and Discover for your portion of the cost of your physical therapy.
  • We will be happy to bill Medicare or your private insurance plan on your behalf. We do not accept Medi-Cal. Prior to your first visit we will collect information from you about your coverage, and we will contact your insurance company for a quotation of your benefits. Of course we can not be responsible for the accuracy or completeness of the information that they provide to us, and we have no control over how they process our claims for payment–ultimate responsibility for the cost of your care will be yours. We will provide you with a detailed explanation of how your plan covers you for physical therapy, along with an estimate of what your personal liability will be. Just give our billing department a call and we will get you started right away.
  • With regard to network participation, it is our firm belief that low cost is not the only determinant of value. In a few cases the contracted network rates offered by particular insurance plans are too low for us to accept given the costs associated with the high standard of care that we provide. We are confident that you will find our services to be a tremendous value whether we happen to be in or out of network with your individual plan.
  • Workers Compensation cases require that all visits be authorized by your employer’s insurance carrier prior to treatment. We will do our best to expedite the authorization process, but depending on the carrier this can sometimes take a couple of days. We appreciate your patience.