Practice Location: 1634 Avenue of the Cities
Moline, Illinois 61265-4860
Phone : 563-940-2481
Fax     : 866-761-7464

First Physical Therapy Visit

Please print out and fill out the New Patient Information form and the payment information related with your insurance. Fill them out and bring them to the first visit.
Please print clearly in BLACK ink, thanks.


Attendance Policy

Your success in Physical Therapy is dependent on regular attendance. There is often a wait of 2 to 6 weeks for new patients to start therapy, and I often have a waiting list of patients needing treatment. Please provide 24 hour notice if you are unable to attend. This gives me time to call those on the cancellation list.

Failed appointments or those cancelled after 24 hours will be charged a $50 cancellation fee
Repeated failures to attend will result in re-evaluation of your need for therapy. Emergencies or weather cancellations will not be charged the cancellation fee.

Please help me to provide the best care possible for you and others.


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