Patient Info
For your convenience, you can download the form below, fill it
out, and bring it with you for your initial
evaluation. Please fill out the "Current Symptoms"
portion of the form
just prior to your visit so that you can provide the most
accurate description possible of your current condition.
If you are scheduling for a patient under the age of 14, please complete only the Pediatric Form.
If you are scheduling for a patient under the age of 14, please complete only the Pediatric Form.
| - | Patient Information Form |
| - | Pediatric Patient Information Form |
| - | HIPAA - Patient Rights and Privacy Information |
Mountain Town Rehab ~ the premier choice for physical therapy
in Central Michigan.
April 9, 2025
MOUNTAIN TOWN REHAB
1106 W High St., Mt. Pleasant, MI 48858
Phone: (989) 779-2920 Fax: (989) 772-9424
Email: info@mountaintownrehab.com
MOUNTAIN TOWN REHAB
1106 W High St., Mt. Pleasant, MI 48858
Phone: (989) 779-2920 Fax: (989) 772-9424
Email: info@mountaintownrehab.com