Resource Library

Resource Library Capitola Physical TherapyWe’ve put together some documents you might find helpful as you improve your performance and health.  Just click on the document title and you will receive a pdf version.  Thank you!

This document overviews the critical considerations to creating a healthy work environment for yourself.  Please click the title of the form to download.  Thank you!

How To Adjust Your Work Station

This document describes how you can safely reach to avoid injury.  Please click the title of the form to download.  Thank you!

Reaching Safely

This document describes how you can safely life heavy objects to avoid injury.  Please click the title of the form to download.  Thank you!

Lifting Safely

This document describes how you can avoid injury.  Please click the title of the form to download.  Thank you!

Finding Your Safety Zone

This document describes how your chair should be set up to maximize good posture and avoid repetitive strain and injury.  Please click the title of the form to download.  Thank you!

Adjusting Your Chair

This document describes how you can safely manage and move heavy materials in a work environment to avoid injury.  Please click the title of the form to download.  Thank you!

Material Handling Instructions

This document describes what good posture is and how to maintain it standing and sitting.  You can also find this information on our Physical Therapy FAQs web page.  Please click the title of the form to download.  Thank you!

Posture FAQs

This document describes how you can maintain a neutral wrist position to avoid injury.  Please click the title of the form to download.  Thank you!

Keep Your Wrist Neutral to Prevent Injury

This document describes how you can care for your back to recover from, avoid, and reduce back injury.  Please click the title of the form to download.  Thank you!

The Back Booklet

Insurance and Intake Forms

Capitola Physical Therapy Medical Forms

We look forward to seeing you!

We have a 2 part form package for you to download, fill out, and bring to your first appointment.

1. Please select your insurance type below, then click the form name to download the forms to fill out and bring to your appointment.

2. Then go to the second set of choices below the insurance list on this page to select the area of the body that is most problematic for you, click the form name to download the form, fill it out and bring it with you.

We ask that you give us this information about the way your problem is making your life functions difficult. We use that information to ensure we are delivering the right treatment (it should improve over time).

Please click the title of the form to download, complete, and bring with you.  Thank you!

Medicare Forms

Please click the title of the form to download, complete, and bring with you.  Thank you!

Workers Compensation Forms

An HMO through Medicare Advantage, Blue Sheild, Blue Cross, United Healthcare, Aetna, etc. all with PMG on your card.  Please click the title of the form to download, complete, and bring with you.  Thank you!

PMG Forms

Blue Shield, Blue Cross, Cigna, Aetna, etc. Please click the title of the form to download, complete, and bring with you.  Thank you!

PPO Forms

Please click the title of the form to download, complete, and bring with you.  Thank you!

Cash Pay Forms

Please click the title of the form to download, complete, and bring with you.  Thank you!

Third Party Payment Forms

Here is the second part of the forms package.  Please choose the area of your body that is the most problematic for you and click the form name to download.

If you are not sure… or if there are multiple areas… pick the best one, and fill it out.   But come in early to make sure we can help you get the right one!

Please click the title of the form to download, complete, and bring with you.  Thank you!

Head, Neck, Upper Body Intake Form

Please click the title of the form to download, complete, and bring with you.  Thank you!

Shoulder Intake Form

Coming soon

Please click the title of the form to download, complete, and bring with you.  Thank you!

Wrist and Hand Intake Form

Please click the title of the form to download, complete, and bring with you.  Thank you!

Lower Back Intake Form

Please click the title of the form to download, complete, and bring with you.  Thank you!

Pelvis and Hip Intake Form

Please click the title of the form to download, complete, and bring with you.  Thank you!

Knee Intake Form

Please click the title of the form to download, complete, and bring with you.  Thank you!

Ankle and Foot Intake Form

Please click the title of the form to download, complete, and bring with you.  Thank you!

Medical and Neurological Intake Form

Please click the title of the form to download, complete, and bring with you.  Thank you!

Generic Intake Form