Physical Therapist
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  • About
    • How ProFormance is Different
    • Meet Dr. Duggan
    • What People Say About ProFormance
  • Services
    • HSV Physical Therapy: Prime & Tune-Ups
    • Athens Physical Therapy: Prime & Tune-Ups
    • Comprehensive One Stop Shop
    • Dry Needling
    • Stretch Clinic
    • BFR: Blood Flow Restriction
    • Performance & Sport Training
    • Concierge Visits
  • Patient Info
    • New Patient Paperwork
    • Insurance and Billing
    • FAQ
    • Pay Your Bill
  • Crossfits and Gyms
  • Blog & News
  • Contact

New Patient Paperwork

Patient Treatment Referral

PLEASE NOTE: Alabama is one of the last states in which you must have a referral/prescription for some “Physical Therapy” treatment. Evaluation of your injury can be completed without a referral, but treatment cannot start without one unless you have been seen by a MD, DO, Physician’s Assistant (PA), Nurse Practitioner (NP), Dentist, Podiatrist, or Chiropractor for the same condition within the past 90 days . A new referral for treatment can also come from an MD, DO, Physician’s Assistant (PA), Nurse Practitioner (NP), Dentist, Podiatrist, or Chiropractor licensed anywhere in the United States. Some insurances require a referral regardless. 

You can bring the referral with you or have him/her fax it to 256-513-9952. If you arrive to the initial appointment without having secured a PT referral, evaluation can be completed but no treatment after the first visit can be performed. The price of the session will remain the same. Below is a referral form that you can take to your provider to have signed. Please contact us if you are having difficulty with getting a referral. 
**Wellness services do not require a referral**
patient_referral_form.pdf
File Size: 142 kb
File Type: pdf
Download File


New Patient Packets

Please download the Intake Forms along with only one survey specific to your problem. Download the PDF files, print, and fill out all forms prior to your first appointment. If you have any questions, please call our office at 256-203-3804.
Patient Intake Forms
File Size: 349 kb
File Type: pdf
Download File

Shoulder, Elbow, Hand
File Size: 66 kb
File Type: pdf
Download File

Hip, Knee, Ankle, Foot
File Size: 241 kb
File Type: pdf
Download File

Neck
File Size: 21 kb
File Type: pdf
Download File

Back
File Size: 23 kb
File Type: pdf
Download File

TMJ
File Size: 658 kb
File Type: pdf
Download File

Headache only
File Size: 89 kb
File Type: pdf
Download File

Global Pain
File Size: 193 kb
File Type: pdf
Download File

Dizziness
File Size: 648 kb
File Type: pdf
Download File


Medical Record Release Authorization

If you feel that you have medical records you would like me to review and consider while creating your plan of care, please download, print, and fill out the first page. Bring both pages with you to your evaluation. You may also email, fax, or snail mail them to me prior to your evaluation, so I can go ahead and fax them to your other medical provider.
Medical Record Release Authorization
File Size: 231 kb
File Type: pdf
Download File


Patient Privacy Notice

privacy_policy.pdf
File Size: 158 kb
File Type: pdf
Download File

ProFormance Would Love to start helping you live pain free now!


Huntsville Location

Inside Crossfit Invigorate
​162 Export Circle NW
​Huntsville, AL 35806

Athens
​Location

Inside Life Changing Fitness
​1104 Annie Ruth Jamar St
Athens, AL 35611
​​

​Hours

Mon-Thurs: 8am - 5pm
​Friday: 8am-5pm

Contact numbers

Scheduling: 256-203-3804
​
Billing: 256-203-0376
​Fax: 256-513-9952

Email

MDuggan@ProFormanceHSV.com
​

  • Home
  • About
    • How ProFormance is Different
    • Meet Dr. Duggan
    • What People Say About ProFormance
  • Services
    • HSV Physical Therapy: Prime & Tune-Ups
    • Athens Physical Therapy: Prime & Tune-Ups
    • Comprehensive One Stop Shop
    • Dry Needling
    • Stretch Clinic
    • BFR: Blood Flow Restriction
    • Performance & Sport Training
    • Concierge Visits
  • Patient Info
    • New Patient Paperwork
    • Insurance and Billing
    • FAQ
    • Pay Your Bill
  • Crossfits and Gyms
  • Blog & News
  • Contact