Williston - (802) 860-4360
Burlington - (802) 657-7990
Shelburne - (802) 985-9360

Preparing For Your Visit

We are happy that you've chosen PT360 for your rehabilitation needs!  We believe in a team approach to achieving overall health and wellness, and are excited to get started on this journey with you.  To access our forms online, you may need to download the latest version of Adobe Acrobat Reader.

 

 

Patient Forms

New Patients

Please fill out these four forms and read the Notice below prior to your first visit.  Completing them ahead of time will allow your therapist more time to perform your evaluation and possibly provide treatment.  You can email them directly to administrator who scheduled you or bring them with you to your first appointment.

Health History Form

Patient Information Form

Authorization Form

Payment Policy Form

Notice of Health Information Privacy Practices

 

Returning Patients

If you are a returning patient and have not been seen this calendar year, please fill out the three forms below and read the Notice prior to your appointment.

Health History Form

Authorization Form

Payment Policy Form

Notice of Health Information Privacy Practices

 

Initial Evaluation

Your initial evaluation is very important for your therapist to develop a plan of care to address your specific therapy goals, so please arrive 15 minutes early if you have not been able to fill out our intake paperwork ahead of time.  You should also bring your insurance cards and referral (if required).  You will need this time to review and sign our cancellation policy, in addition to any functional questionnaires that your therapist may need to fully assess your physical health.  Arriving early ensures that your therapist will have enough time to discuss your current condition, take appropriate measurements, administer functional tests, and determine a plan of care to address your goals for therapy.  If time allows, your therapist will also begin treatment to start you on your journey to health and wellness.

 

Please bring comfortable clothes to your first visit so that your therapist can fully assess your physical condition, as many of our tests and measurements require movement to accurately diagnose certain injuries and conditions.  You may also need a pair of sneakers if you are having your walking mechanics or balance evaluated.

 

It is also a good idea to bring your schedule book or personal calendar so that you can make follow-up appointments right after your initial evaluation.  We automatically enroll all of our patients in our Appointment Reminder system at their first visit, which provides 48 hours notice for upcoming appointments via phone call, text, or email.

 

Additional Information

As of January 1, 2022, consumers have new billing protections when getting emergency care, non-emergency care from out-of-network providers at in-network facilities, and air ambulance services from out-of-network providers. Through new rules aimed to protect consumers, excessive out-of-pocket costs are restricted.  We've attached the following disclosure to help you understand your rights and protections against surprise medical bills.

No Surprises Act Disclosure