Patient Forms
Thank you for choosing Energy Physical Therapy LLC, for your physical therapy needs.
Please download, print and sign these forms and have them ready for your first appointment.
Prescription Form - to give to your doctor
If your doctor has not yet provided a prescription for physical therapy, you can print this form and bring it to your doctor to complete and sign.
EnergyPT-script.pdf
Adobe Acrobat document [221.6 KB]
If your doctor has not yet provided a prescription for physical therapy, you can print this form and bring it to your doctor to complete and sign.
EnergyPT-script.pdf
Adobe Acrobat document [221.6 KB]
HIPPA Notice of Privacy Practices
Please read the HIPPA form. As part of the consent form, you will acknowledge that you were provided and read this HIPPA notice.
NOTICE OF PRIVACY PRACTICES.pdf
Adobe Acrobat document [87.5 KB]
Please read the HIPPA form. As part of the consent form, you will acknowledge that you were provided and read this HIPPA notice.
NOTICE OF PRIVACY PRACTICES.pdf
Adobe Acrobat document [87.5 KB]
Energy Physical Therapy
Serving Pottstown and neighboring areas
On the move to help YOU
get moving again!
click map to view our service area
“No matter what health issues or injuries life sends your way, you can maximize your daily quality of life with the right treatment and training.”
Dr. Julie Adamski
founder, Energy Physical therapy
Print