Gilford Physical Therapy & Spine Center
689 Gilford Ave
Gilford, NH 03249
P 603.528.4152
F 603.528.1591
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New Patients

Be prepared for your first appointment! Please bring:
  1. The Patient Paperwork filled out completely. If you're unable to print it at home, you must arrive 30 minutes early.
  2. Your insurance card(s).
  3. Your referral/prescription for physical therapy from your doctor.
  4. An updated, accurate medication list.
  5. A form of payment for your deductible, co-insurance, or copay. We accept checks, MasterCard, Visa, Discover, and cash. Payment is due at each visit.
  6. Your operative report and/or any imaging reports, if applicable.
  7. An extra pair of shoes or slippers to change into upon arrival - patients may be exercising on the floors, and we like to keep them clean!
  8. Your claim and adjustor information if this is a worker's compensation case or auto accident.

Paperwork

To fill out the paperwork digitally, right click on "download file" below and "save link as". Open the saved document in a PDF reader such as Adobe, fill out, print & sign.
Patient Paperwork - Fillable PDF
File Size: 682 kb
File Type: pdf
Download File

Alternatively, use the link below to print the paperwork and fill out by hand.
Patient Paperwork - Handwritten
File Size: 692 kb
File Type: pdf
Download File

Read our privacy practices and office policies. You do not need to print them or bring them in.
Office Policies & Privacy Practices
File Size: 1535 kb
File Type: pdf
Download File





  Site last updated: 
​11/13/2020
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