Patient Forms

In order to receive physical therapy services in the state of Texas, one must be referred by a qualified medical professional:

  • Medical Doctor (MD)
  • Doctor of Osteopathy (DO)
  • Podiatrist (DPM)
  • Physician Assistant (PA)
  • Advanced Nurse Practitioner (NP)
  • Dentist (DDM)

New patients can bring a referral at the time of their initial appointment or have it faxed to our office at (806) 331-6085.

If you arrive for a scheduled initial visit without a referral, an evaluation may be performed but any treatment or consultation must, by law, be postponed until a referral is provided.

Wellness services (AlterG Treadmill, Video Analysis, Injury Prevention Screening, Maintenance Services, etc.) do not require referral and may be scheduled at your convenience.

If you have questions regarding referrals, please contact our office.

Patient Intake Form

For your convenience, our Patient Intake Form may be accessed here and completed prior to your appointment. Please arrive a few minutes early if you would prefer to complete the form in the office.

Click here to print the iPOW Patient Registration Form now!