New Patient Information

1st In Health
Aetna
Affordable
Alliance PPO
Anthem BCBS of VA
BCBS FEP
BCBS CareFirst
BCBS PPO
Blue Ridge Health Alliance
Champus
Choice Care
Cigna
Fidelity PMG Network
First Health
GEHA
Guardian
Integrated Health Plan
Kemper
Mailhandlers
MAMSI
MDIPA
Medicare
Mutual of Omaha
NCPPO
One Health Plan
Optimum Choice
PHCS
Prince William County Public Schools
Qual Choice of VA
Tricare
United Healthcare
VML CompCare
Workers Compensation Plans

For you first office visit there are a few things that you must have:
* Health Insurance Card
* Doctor's Prescription
* Physician referral
* Drivers License or Government ID

You can print and fill out the Registration and HIPAA Consent form prior to your first visit to save time. Otherwise please arrive 15 minutes prior to your first visit to allow time to complete the proper paperwork.

Please call our offices if you need to schedule an appointment or have to miss your scheduled appointment.
If you are more than 15 minutes late for your scheduled appointment it may be necessary to reschedule your visit so that we do not inconvenience our other patients. As we do run behind on occasion if the therapist's schedule experience a significant delay we will try to contact you for a reschedule if possible.
Please notify us a minimum of 24 hours in advance if you are unable to keep your appointment as this will allow us to accommodate those who may need care that day.
There is a $25 charge for ALL NO SHOW or NO CALL visits, this also may apply to Same Day Cancellations if you cancel less than 2 hours prior to the visit.

Our service is founded on providing specialized care performed by skilled licensed physical therapists.
Some of those services include:

* Sports Medicine
* Post-Surgical Rehabilitation
* Neurological Rehabilitation
* Spinal Physical Therapy
* Vestibular
* Whiplash
* Neck and Back Pain / Scoliosis
* Arthritis
* Shoulder & Knee Injuries or Disorders
* Gait / Walking Difficulty
* Ergonomics

If you need to request an electronic copy of any of our forms please email us.
Technical@PerformancePT-LLC.com
We will respond to your request as quickly as possible.
You can open our Registration Form, HIPAA Consent Form, & Company Privacy Statement on this screen.