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Edina:  952.922.0330   |   Mpls:  612.339.2041

OrthoRehab – Edina Physical Therapists

OrthoRehab - Edina Physical Therapists

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Forms

Patient Forms & New Patient Registration

To help make your first visit to our Edina or Minneapolis clinic as smooth and efficient as possible, we encourage you to complete the necessary patient forms in advance. By filling out these documents ahead of your appointment, you’ll save time at check-in, allow our team to review your medical history beforehand, and help ensure that more of your visit is focused on your evaluation and personalized treatment. You have several convenient options for completing the paperwork. You may download, print, and complete the forms at home, or request electronic versions to be sent to you via email. If it’s easier for you, we also welcome patients to fill out all paperwork upon arrival at the clinic. Whatever option you choose, we are here to assist and ensure your experience gets off to a great start.


Request Electronic Forms

Why Complete Forms Early?

  • More Treatment Time: Avoid spending your session filling out paperwork.
  • Better Preparation: Our therapists review your health history before your evaluation.
  • Fewer Delays: Ensure all required consents and authorizations are in place.
  • Enhanced Accuracy: You can gather records and details ahead of time.

Checklist for Your First Visit

Please bring the following items along with your completed forms:

  • Photo identification (driver’s license or state ID)
  • Insurance card(s) and referral if required
  • Completed Patient Information Form
  • Signed Acknowledgement of Receipt of Notice form
  • Signed HIPAA Authorization
  • Signed Medical Information Release
  • Any relevant imaging reports or test results
  • List of current medications and dosages
  • Comfortable clothing for movement assessment

Form 1: Patient Information Form

This form gathers your personal details, medical history, and current health status so our therapists can develop a safe and effective plan. It includes:

  • Demographics: Name, date of birth, address, phone, and email
  • Emergency Contact: Name, relationship, phone number
  • Primary Care Physician and specialist contacts
  • Health History: Past surgeries, chronic conditions, allergies
  • Medications: Prescription, over-the-counter, supplements
  • Social History: Work, activities, exercise habits
  • Functional Limitations: Activities that are difficult or painful

Download here: Patient Information PDF. Proper completion helps us tailor your physical therapy services to your specific needs.

Form 2: Acknowledgement of Receipt

Minnesota law requires that we provide and document your receipt of our Notice of Privacy Practices. This form confirms you have been informed of how we collect, use, and safeguard your personal health information. It covers:

  • Your rights to access and amend your records
  • Our commitment to confidentiality
  • How to report any privacy concerns

Download here: Acknowledgement PDF. For details, see our Privacy Policy.

Form 3: HIPAA Authorization

This authorization allows us to share or obtain your medical records with other providers. It can be used to:

  • Request diagnostic imaging (MRIs, X-rays) from hospitals or clinics
  • Share treatment plans with your primary care or specialists
  • Coordinate care for surgery, injections, or other interventions

Download here: HIPAA Authorization PDF. This helps us provide seamless, integrated care.

Form 4: Medical Information Release

When you have outside imaging or specialist reports, this release grants us permission to retrieve and review those documents. This can:

  • Prevent duplicate tests
  • Speed up treatment planning
  • Ensure we have a full understanding of your condition

Download here: Medical Information Release PDF.

Digital Form Completion

If you prefer to complete forms online or via email, contact our front desk. We will send you secure, fillable PDF links or electronic forms that you can submit before your appointment. Email your request to staff@orthorehabpt.com or call 952.922.0330.

Tips for Accurate Form Completion

  • Use black or blue ink when printing forms.
  • Answer all questions thoroughly; incomplete sections may delay care.
  • If something does not apply, write N/A rather than leaving it blank.
  • Review medication names and dosages carefully.
  • Bring any lab results, imaging reports, or referral letters you have.

Clinic Resources

To prepare further for your visit, explore these resources:

  • New Patient Information – What to expect on your first visit
  • Manual Therapy Services – Techniques we use to relieve pain and improve mobility
  • Functional Testing – How we assess movement patterns and strength
  • Top 10 Physical Therapy Exercises – Exercises you can begin at home

Frequently Asked Questions

Can I complete forms at the clinic?
Yes, we provide printed forms as well as tablets for your convenience when completing necessary paperwork. While you are welcome to fill out these forms upon arrival, completing them in advance helps to speed up the check-in process and allows more time for your evaluation and treatment. Our goal is to make your visit as efficient and comfortable as possible, so you can focus on your care without unnecessary delays.
What if I cannot print at home?
Call us at 952.922.0330 and we will mail you paper copies or email a fillable PDF.
Are my forms secure?
Yes, absolutely. We take your privacy and the security of your personal and medical information very seriously. All data is managed in strict compliance with HIPAA regulations to ensure your information remains confidential and protected at all times. When you submit documents electronically, we use encrypted email systems or a secure online portal designed specifically to safeguard your sensitive information. Our commitment is to maintain the highest standards of security so you can feel confident that your privacy is fully respected throughout your care experience.
What if I need help understanding the forms?
Our front desk and clinical staff are always available to assist you with any questions or concerns you may have. Whether you prefer to speak with us over the phone before your appointment or need clarification when you arrive at the clinic, our knowledgeable and welcoming team is here to provide clear, helpful answers. We want to ensure that you feel comfortable and informed every step of the way.

Next Steps

Completing your forms ahead of time helps us provide you with the best possible care by allowing your therapist to dedicate the full first appointment to a thorough assessment and personalized treatment plan rather than paperwork. This preparation not only saves valuable time but also helps us understand your medical history and needs before you even walk through the door. To get started, please download and complete your patient forms now:

  • Patient Information PDF
  • Acknowledgement of Receipt PDF
  • HIPAA Authorization PDF
  • Medical Information Release PDF
Contact Us for Assistance

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Disclaimer:

The information contained on this site is intended to provide only general education. It should NOT be regarded as diagnostic, treatment or any other type of specific medical advice to anyone. Individuals should always consult a licensed and qualified health care provider for evaluation, diagnosis and treatment recommendations regarding their specific medical problems. If you think you may have a medical emergency or a major medical problem, call your doctor or 911 immediately.

Ready to get moving?

Contact our Twin Cities physical therapists today.

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Edina Clinic

OrthoRehab Specialists, Inc.
6600 France Ave S #260
Edina, MN 55435

PH: 952.922.0330
FX: 952.922.0990


M-F — 7:00 a.m. to 6:00 p.m.

Insurance Accepted

Medicare
Humana
Blue Cross
Medica
Patient Choice
Cigna
Mn Health Care
UCare
UHC
UMR
Aetna
PHCS/MultiPlan
Americas PPO
Auto and Work Comp

Minneapolis Clinic

OrthoRehab Specialists, Inc.
825 Nicollet Mall #1935
Minneapolis, MN 55402

PH: 612.339.2041
FX: 612.339.2042


M-F — 7:00 a.m. to 6:00 p.m.

Service Area

We provide physical therapy care to patients throughout the state of Minnesota, including the cities of:

Minneapolis, Edina, Andover, Bloomington, Blaine, Brainerd, Brooklyn Center, Brooklyn Park, Burnsville, Chanhassen, Chaska, Coon Rapids, Crystal, Eagan, Eden Prairie, Forest Lake, Golden Valley, Hopkins, Inver Grove Heights, Maple Grove, Maplewood, Minnetonka, New Brighton, New Hope, Orono, Richfield, Rogers, Roseville, St. Louis Park, Stillwater, Vadnais Heights, Wayzata, Winona, and more!

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