Progressive Therapy
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  • Meet The Team
    • Ellen Hudgins, OTD, OTR/L
    • Aislin Dulio, COTA
    • Tim Smith, PT
    • Caitlyn R. Wood, PT, DPT
    • Brittany Lanahan, LPTA
    • Lara White, LPTA
    • Sheila Hall Strigel, M. Ed, CCC-SLP
    • Whitney Traynham, LPTA
    • Julie Long, Rehab Tech
    • Lilly Carter, Rehab Tech
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    • New Patient Forms
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New Patient Forms

If you would like to fill out the new patient forms before your first appointment, please download and print the New Patient File below. Please complete both pages and remember to bring these in with you to your initial evaluation. 

New Patient Forms
​Please feel free to fill out your paperwork before your Initial Appointment and bring it with you!

Medical History Form:

medical_history.pdf
File Size: 116 kb
File Type: pdf
Download File

Financial Policy:

financial_policy_072019.pdf
File Size: 441 kb
File Type: pdf
Download File

Cancellation Policy:

cancellation_policy.pdf
File Size: 84 kb
File Type: pdf
Download File

Demographics:

demographics[1593].pdf
File Size: 36 kb
File Type: pdf
Download File

A doctor's referral is required:

script.pdf
File Size: 17 kb
File Type: pdf
Download File

Please Note:

  1. Your insurance may require a prescription, order, or referral from your doctor in order to receive treatment. It must be up-to-date (signed by your doctor within the last 30 days).  If you have not yet received a prescription, contact our office to see if your insurance participates in Direct Access! 
  2. ​If you have been admitted to a hospital since your last visit you must have a doctor's note approving the continuation of therapy before we can begin treatment again.​
  3. ​If you were receiving Home Health therapy you must be discharged before we can begin treatment.
  • Home
  • About Us
    • Locations >
      • All Locations
      • Farmville Clinic
      • Dillwyn Clinic
      • Blackstone Clinic
    • Who We Are >
      • Our Story
      • Career
      • Volunteer Resources
    • Announcements >
      • Community
  • Services
    • Physical Therapy
    • Occupational Therapy
    • Speech Therapy
    • Industrial Rehabilitation
    • Vestibular Rehabilitation
    • Additional Services
  • Meet The Team
    • Ellen Hudgins, OTD, OTR/L
    • Aislin Dulio, COTA
    • Tim Smith, PT
    • Caitlyn R. Wood, PT, DPT
    • Brittany Lanahan, LPTA
    • Lara White, LPTA
    • Sheila Hall Strigel, M. Ed, CCC-SLP
    • Whitney Traynham, LPTA
    • Julie Long, Rehab Tech
    • Lilly Carter, Rehab Tech
  • Patients
    • New Patient Info
    • New Patient Forms
    • Direct Access
    • FAQ
    • Contact Us
  • Providers
  • Contact Us