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Patient Registration Forms //

Active Spine Physical Therapy welcomes you to our practice.  


Once you have made your initial appointment, you may pre-register by downloading, printing, and completing the forms below. Please be sure to bring them with you to your first visit, along with a photo ID, your insurance cards, and any diagnostic films or other test results that may have been ordered or performed by another physician. Completing the forms prior to your visit will help speed up the new patient registration process.

Patient Payments
Testimonials //


I worked with Erik for several months during rehabbing from spinal surgery. He also helped with my hip bursitis. Lots of different exercises to rehab both areas. He was very good at explaining what each exercise was doing and offered great encouragement through the whole process. Scheduling of appointments was very flexible. A plus is each day I am feeling better and stronger. I have always been very active and I believe I am well on my way back.


 Back Surgery/Hip Bursitis Patient

Jay is great to work with. Very laid back, doesn’t make you feel like you’re training for a marathon when you’re there for pain management. Too many PT’s think more is better but when you’re in pain it’s definitely not! Thanks Jay!


Low Back/Knee Pain Patient

I just wanted to say thank you so much for your wonderful care of me and my back. This was hands down the best PT experience that I have ever had. If I ever need therapy again, or know someone who does, you are top of the list! I appreciate everything, from working around my hectic schedule, to Sara's excitement for my wedding gown shopping! You guys are wonderful!


Mid-Back Patient

Nick was great to work with! I’ve had nagging lower back pain for a while and my new PT regimen from Active Spine has radically improved things. While I learned new exercises and stretches we discussed little things that could have added to my pain. How I walked, slept, everything. Every visit ended with a new sheet of exercises I could do at home. I genuinely felt like the goal was not to keep me coming in, but to reduce my back pain and help me address it on a day to day basis. Tragically, Nick is a Bears fan, but nobody’s perfect.


Low Back Pain Patient

Erik at Active Therapy was great. He has a high level of skill and knowledge of getting me back to feeling really good again. I am sure if I should need therapy in the future I will choose Active Therapy.


Back/Neck/Shoulder Patient

Health plans //

One of the best things about Active Spine Physical Therapy is that we work with almost all major insurance carriers (inlcuding Medicare and Medicaid) and we participate in many local provider networks.


Our front office staff will work diligently with your physical therapist and insurance company to accommodate your individual needs. 

Frequently Asked Questions //

​​​​​What should I expect at my first visit?

You will be seen by a licensed Physical Therapist who will listen to your concerns and then complete a comprehensive evaluation. Together, a treatment plan will be designed with your goals in mind.

What should I wear?

It is suggested that you wear something comfortable that allows you to move freely and allows the Therapist access to the area of your body you are seeking treatment.

Do I need a referral/prescription from a doctor to see a Physical Therapist?

All 50 states have passed legislation that allows direct patient access to a physical therapist without a physician referral. You may be seen by a licensed Physical therapist as long as it is medically necessary, which will be determined by the treating therapist.


Physical therapists are educated at the post-baccalaureate level receiving extensive education and clinical training in the examination, evaluation, diagnosis, prognosis, and intervention of patient/clients with functional limitations, impairments and disabilities.


Physical therapists are qualified to recognize when a patient presents with signs and symptoms inconsistent or outside the scope and expertise of the physical therapist and when the patient should be referred to a physician.

Will my treatment be covered if I come by direct access?

Some insurance agencies may still require a prescription for physical therapy from your doctor. All Medicare patients do NOT require a prescription. You will be covered by your healthcare physical therapy benefits as long as it is approved by your insurance and you have not exhausted your annual allowance. We always recommend that you call the number on the back of your insurance card to find out what your physical therapy benefits allow.

I have additional questions regarding my first appointment and condition, whom should I contact?

Please feel free to call or email us at with any additional questions.

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