Physical Therapy Intake Form Template (+ an Alternative Option)

Author: Paul Singh

Your physical therapy intake form is one of the first engagements between your clinic and a new patient. This means it’s not just a way for you to collect demographic or clinical information. Your physical therapy intake process also:

  • Makes sure you have what you need to deliver correct treatment and be compliant—including a patient’s medical history and symptoms, along with their payment details. 

  • Ensures you get paid. While many clinics treat billing as something to deal with after seeing a patient, reimbursement actually starts with accurate documentation—which begins with your patient intake form. In short, your intake form can be the difference between getting reimbursed and having to handle denied claims.

  • Saves you time later on. For example, if using a separate intake form, you’ll duplicate data entry by transferring details from a paper or electronic form to your EMR.

  • Creates an impression of your clinic among patients. Complete, attractive, and branded intake forms will help you build a reputation for professionalism. First appearances matter.

Rather than drawing up a professional and comprehensive patient form from scratch, you can check out the two examples below and use them to develop your own physical therapy intake form template:

(Note: These are third-party templates—we’re not affiliated with these companies.)

These form templates give you everything you need, including fields for a patient’s identifying information (such as their date of birth and other demographics), their medical information, and insurance and referral details. It also includes HIPAA acknowledgement—so patients know you’re treating their data in a secure, compliant way. 

However, it’s important to remember: a downloadable template isn’t actually the most convenient way to intake a patient. With a paper document like this, you’ll give yourself extra admin, while failing to make the patient experience as smooth as it could be. 

That’s why, at StrataPT, we give physical therapists a much better way to do their patient intake.

In this post, discover how our platform, StrataEMR, helps you create an intake process that leads to higher reimbursement rates and more satisfied patients.

How to improve your physical therapy intake (with StrataPT)

When there’s so much riding on your physical therapy intake form, it’s not the best idea to just take one from the internet—even if it does give you the basics of what you need. 

That’s because your intake process should be geared towards getting your clinic paid. While many of the downloadable forms out there have pretty templates that tick the right boxes, they rarely help you get reimbursed for the work you do. 

With StrataEMR, your patient intake process—and every other documentation workflow—is deeply integrated with your billing and RCM processes. This allows us to help PT clinics achieve a reimbursement rate of higher than 99%. Our platform’s digital intake forms will streamline your admin and set you up for a clean, compliant, claims process.

In the rest of this post, we’ll explain how you can make this possible for your PT practice. 

1. Adopt a digital intake process

Paper intake forms are a hassle for clinicians, admin staff, and patients. 

This is because they need to be printed out, manually completed and signed by patients, and then all that patient information needs to be copied into your computer system. 

When using StrataEMR, you can go completely paperless and streamline this whole process. By digitizing your patient intake, you’ll save time and improve the experience for everyone with the following features:

  • Digital patient portal. With StrataEMR, every patient in your practice gets their own unique portal, where they can see all their communications with you. This lets you create a custom, personalized area for each patient, where they can find the key documents they need.

    To create a simple intake process, all you need to do is upload the documents patients need to complete before they see your clinician—whether that’s a consent form, health insurance information, or privacy declarations. Patients will be notified electronically that these documents need to be completed and they can resubmit them all to you within the dashboard.
Example of Client View: Consent and Policies, Benefits Confirmation, Patient Registration Form, Health Questionnaire (Balance Due: $123.45)
  • Electronic patient signature. Nothing needs to be printed at all. Patients can simply access the portal on their device and sign electronically using their finger. You’ll save them time and cut down on unnecessary pieces of paper. 

  • PT patient intake form templates. Of course, we can provide a template for your forms, so you don’t need to spend time thinking about what to include. You can move quickly and start seeing your patients immediately.
Patient Intake Form for Jimmy Babcock: Physical Therapy Associates, Lake Shore

But StrataEMR’s patient portal isn’t just for intake forms. Patients can receive appointment reminders, manage their payments, and make cancellations, too. (More on this below.)

2. Save time with auto-populated documentation

One way that PT clinics are being held back is that they don’t have a single system to manage their practice from patient intake through to billing and practice performance data. 

Instead, many practices typically use their paper forms alongside a mix of tools that are each responsible for an individual task. For example, you might use one software to handle your documentation, another to store patient contact information, plus a spreadsheet (and perhaps an external billing service) to stay on top of your billing and RCM. 

This might work for a while, but as your practice grows, you’ll find that this kind of messy setup creates a heavy workload. Instead, it helps to use a single tool to handle all of your practice management processes—including your patient intake. 

That’s exactly what StrataPT provides. You can cut down admin with the following features:

  • Auto-populated clinical documentation. When patients complete your intake form, the information they provide will be automatically transferred to your clinical documentation. 

  • Documentation templates based on insurance details. For example, if your patient tells you they’re insured by Medicare in their intake form, you can use a documentation template with the CPT code combinations and billing protocols relevant to that insurer. This way, you’ll ensure that the treatment you issue is certain to be reimbursed by the payer. 

  • All patient information is in the same place. Have a single source of truth for everything in your practice, including contact details, symptoms and evaluations, and referring physicians.

With StrataEMR, you can bring all of your practice management processes under one roof. It’ll save you time and help you cut software costs, while giving you the confidence that all the treatment you’re giving will get reimbursed.

Now in our 15th year in business, having StrataPT on our team has made our practice so much more streamlined. The EMR is simple and easy to use. The screens flow well and have cut our documentation time down by at least 30%. The billing side has increased profits by 20% as well… By having StrataPT help, we have freed up more space in our office so we can focus on the quality of care we provide to our patients. I am very glad we found StrataPT when we did, we can’t imagine working without them!

– Brenton H., co-owner of Genesis Physical Therapy

3. Ensure you comply with payer rules and get reimbursed

PT billing and compliance is a huge headache for clinics of all sizes. Billing rules and protocols often change, while practices are typically encouraged to see their billing and their documentation as two separate concerns to be handled separately. 

Consequently, clinics often see over 20% of their reimbursement claims get denied, through incorrect or incomplete submissions. 

As we noted above, the way that you manage the entirety of your practice—from patient intake to documentation—contributes to the success of your billing processes. That’s why compliance needs to be built into everything you do. 

Here’s how your patient intake form from StrataEMR can help:

  • It contains all the information you need to be compliant with insurance providers. Different insurers require that you collect different information on your patients. With StrataEMR, you can trust that you know everything needed to ensure a complete claim.

  • Up-to-date payment protocols and billing codes. We keep our system up-to-date so that you don’t have to worry about CPT codes, rules, or modifiers ever again. You won’t be blindsided by changing regulations or protocols. Instead, you can just focus on patient care. 

  • Real-time Medicare eligibility. See immediately whether a new patient is eligible for Medicare from the information they’ve provided in their intake process. 

Having a system that encompasses everything from scheduling to billing to patient intake to documentation has made our practice be more productive and it has made it a more well-rounded and complete business.

– Sonia M., co-owner and director of operations at PT Doctors of Florida

3 more ways to boost patient satisfaction with StrataPT 

With StrataEMR, your practice doesn’t just benefit from improved intake processes and compliance. Instead, you can deliver a better experience to your patients in other ways, too. 

Build yourself a reputation for professionalism and great patient experience with these three features:

  1. Appointment reminders. Automatically send your patients a notification about their appointment before they arrive, including the details of any forms they need to complete. You’ll reduce no-shows and make life easier for them.

  2. Clarity on patient payments. In their portal, your patients can easily see how much they owe and complete their payment. Many of our clinics tell us that this has dramatically improved their collections. 

  3. Satisfaction surveys and data. Ask your customers honestly how they feel about your service. Collect their satisfaction data all in one place to see how you can deliver a better experience. 

Forget physical therapy intake forms. Try a better way to do intake and improve your patients’ experience with StrataPT. 

Talk to an expert to find out how it works for yourself.