We Work With Most Insurance Carriers

New Patient Forms

Printable Form
Online Form

Insurance Information Forms

Printable Form
Online Form

Thank you for your interest in Orofino Physical Therapy! We look forward to meeting and working with you throughout your rehab experience! Please fill out the above form (either submit them online or print them and bring them to your first appointment).  If you have any questions; please print them out; fill them out to the best of your abilities and our receptionist will help you complete them at the clinic.

Insurance Verification:

Your insurance will be verified by us during the first 1 – 2 appointments so that you are fully aware of your payment obligations before treatment begins. It is important that, as a patient, you understand your physical therapy insurance benefits. It is imperative that you personally verify your own benefits as well.

Patients with insurance:

We are set up to collect deductible and co-pay/co insurance each visit or we can offer you:
1) weekly payment plan
2) monthly payment plan

*For weekly and monthly payments agreements must be signed

Patients with no insurance:

3/300 with one month aftercare
5/500 with one month of aftercare
25% discount off of regular fees

Payment agreement should be signed for either weekly or monthly

Patients with 3rd Party MVA/Litigation Cases:

Weekly or monthly payment agreement must be signed. We now require payment each month from the patient on 3rd Party MVA/ litigation cases. We can’t hold accounts until settlement. Those cases can take months to years to settle. If the patient is not willing to make payments on the case continued treatment of patient must be approved by VPA or CEO.