Campus Physical Therapy Center

Filling out our forms prior to your scheduled appointment will not only save you time on the day of your appointment but also reduce the stress and provide more accurate information to your Physical Therapist.

There are two ways you can fill out a form before your visit. First, you can fill out an online form. The information you provide here will be entered into our computer systems and you will only need to verify that the information is correct at the time of your visit. Second, if you would rather not complete the forms online, you can simply click on the PDF icon, print the form out, and bring the completed form with you to your scheduled appointment. These is financial agreement within you, the patient or legal guardian, and Campus Physical Therapy Inc. If you prefer to provide payment through your insurance company, please provide the most up to date information gather from your latest contract.

Online Registration Forms



Financial Agreement

Insurance Information

Online Treatment Consent

Notice of Privacy Practice


PDF Registration Forms

Privacy Practice Forms

A federally mandated form that assure your privacy.

Privacy Practice Form

Workers Compensation Forms

Campus Physical Therapy Inc. may direct you to obtain one or more of these forms to be completed by you and/or your treating physician.

California Workers Compensation DWC 1
California Workers Compensation PR 2

The form is known as "Doctor's First Report of Occupational Injury or Illness" and can be downloaded by clicking here:

If you need a California workers' comp claim form, you can get a DWC-1 claim form by clicking here:


You can download mileage forms by clicking on this link:

Additional Forms

If you need your medical records, please complete the form below. A medical record fee of $60.00 is required. If you have an attorney, please ask him/her to send us a formal request along with the medical record fee and a record release form signed by you, the patient or legal guardian.

Request of Medical Records