Thank you for choosing Merritt Physical Therapy & Rehabilitation as your medical provider!

We’re so glad that you chose us to provide you with professional in-home, or outpatient care. To get started with your treatment, there are a few forms that will need to be completed. You will find those down below to be filled out.

Once printed and filled out, bring them to your first appointment.

Patient Documents & Forms

Please download, print, and fill out all documents down below if you are a new patient at Merritt Physical Therapy & Rehabilitation.

• Patient Information and Medical History

• Assignment of Benefits and Release Information

• Video Surveillance Policy

• COVID-19 Questionnaire

Important Appointment Information

• Fill out all of the documents shown under the “Patient Documents & Forms” section. Once downloaded, printed, and filled out, bring the forms to your first appointment at the Merritt Physical Therapy & Rehabilitation clinic.

• Please arrive 15 minutes before your appointment time if you are unable to complete the paperwork prior to your first appointment.

• All new patients will be required to fill out a COVID-19 questionnaire along with their admission packet.

If you need help finding a Merritt Physical Therapy & Rehabilitation clinic, click here to see a detailed map of each clinic location or give us a call at (276) 935-6496.