Access and Complete Your Therapy Documents Easily

Essential Patient Forms for Your Convenience

Kindly fill out and submit the forms to our HIPAA-compliant email at intake@nextstep-rehab.com. For more information please call our office at (240)-389-2935 or (202)-780-6495.

New Patient Form

Download key documents including Patient Intake, Medicare Authorization, HIPAA, Financial Policies, and Consent to Treatment to prepare for your appointment.
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Insurance Information

Complete forms such as Medical Release, Photo Consent, and Good Faith Estimate ahead of your session to streamline your therapy experience.
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Questionnaires

Please select the form for your treatment area and submit along with your Patient Forms.

For the best experience, please use a desktop computer to view, save, and print these forms.

Lower Back

Download key documents including Patient Intake, Medicare Authorization, HIPAA, Financial Policies, and Consent to Treatment to prepare for your appointment.
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Upper Extremity (Shoulder/Arm/Hand)

Complete forms such as Medical Release, Photo Consent, and Good Faith Estimate ahead of your session to streamline your therapy experience.
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Therapy Tools

Create a Path Forward

Mileage Tracker

Complete forms such as Medical Release, Photo Consent, and Good Faith Estimate ahead of your session to streamline your therapy experience.
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TUG/ 30-sec Chair Test

Download key documents including Patient Intake, Medicare Authorization, HIPAA, Financial Policies, and Consent to Treatment to prepare for your appointment.
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Patient Satisfaction Form

We strive to provide the highest quality care. Please take a few moments to share your thoughts on your recent in-home therapy.


Your honest feedback is anonymous and will be used directly to improve our services for you and our community. This survey should take less than 3 minutes to complete.

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What You Need to Know

  • Which forms do I need to complete before my therapy session?

    Patients should complete the Patient Intake Form, Questionnaire for the treatment area, Insurance Information, HIPAA Authorization, Financial Policy, and Consent to Treatment forms prior to their first appointment to ensure smooth processing.

  • Can I fill out these forms online or only in person?

    All forms are designed to be completed by patient at home to save time during your visit.

  • What if I have questions about the forms or policies?

    Our team is available to clarify any questions regarding the forms or therapy services. Contact us anytime for assistance (240-389-2935).

  • Are there any forms specific to certain treatments or conditions?

    Yes, specialized forms like the Dizziness Handicap Inventory and Falls Efficacy Scale, etc. are included for relevant assessments during therapy.

Talk To Us

Reach out with any questions about your therapy needs or patient forms. Our team is ready to assist you promptly and professionally.

For your privacy, do not include personal medical info, Social Security numbers, or specific health concerns in this form. For confidential information, contact our office at (240)-389-2935 or (202)-780-6495 for secure submission instructions.

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