NC (919) 364-4000    NY (845) 454-4137

Patient Forms

Online Patient Forms

Health Questionnaire
Patient Information Form
Patient Policy Form
Consent for Treatment
Notice of Privacy Practices

Are you a new patient at Moriarty Physical Therapy? If so, you’re in the right place.

We want you to feel at home when you visit any of our clinics in New York or North Carolina. Our patients are our top priority, and we take special care in making sure you have the best experience possible, whether that’s through our comfortable and friendly environment or how we prepare you for your first visit.

The information we gather prior to your first appointment is to help personalize your physical therapy treatment and experience so that you can see the results of that in your recovery. The team at Moriarty PT takes a customized, compassionate approach to physical therapy and will take the time to review your personal medical history in detail before we assess any pain points and make recommendations for treatment. After that, we will work with you to achieve noticeable improvement throughout your entire journey to recovery. We want to have you back to performing the activities you enjoy as soon as possible.

We accept most insurance plans and have options for those without insurance. You can also request physical therapy treatment without a prescription or referral from another healthcare provider. If you’re looking for programs outside the standard physical therapy services, we offer Direct-Pay, which is fee-for-service and allows for a sophisticated level of customization.

When you enter one of our clinics for the first time and at each subsequent visit, you’ll be greeted with a warm smile by our friendly administrative team. From there, you’ll be treated by Doctors of Physical Therapy, whose goal is to make you feel at ease and like part of the family.

We look forward to seeing you at your first appointment.

For your convenience, we’ve made our patient forms available to you ahead of time, and they can be accessed below. Please download, complete and sign the forms, and bring them with you to your first appointment.

If you have questions, don’t hesitate to reach out to us at NC (919) 364-4000 or NY (845) 454-4137

.

Schedule a FREE 15-minute Exploration Visit

Come visit one of our physical therapy clinics in New York or North Carolina and one of our Doctors of Physical Therapy will do a 15-minute consultation to see if physical therapy is right for you. In the consultation, we’ll help determine the source of pain and movement restrictions to see if you would benefit from physical therapy or might need the assistance of another healthcare professional. If so, we’ll make a referral and help speed up achieving your health goal.

You have nothing to lose; the screening is free! And if physical therapy could help you, we can perform the examination right then–even without a prescription–with Direct Access (covered by insurance).

Learn More
Back To Top