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PRS PT Appointment Request - 2019

Initial Questions

1. What type of specialist are you looking for? *This question is required.
Please complete the following Direct Access Physical Therapy form and our staff will help you find a physical therapist who best fits your individual needs.

Direct Access Physical Therapy is the ability to be evaluated and treated for non-surgical injuries or orthopedic conditions by a physical therapist without a physician prescription.

If you prefer, you may also call us at 800.493.0039. (Monday to Friday, 9:00 AM - 5:00 PM, ET)
 
If you would like to speak with an HSSConnect representative for help with finding a physician who best fits your individual needs, please call us at 877.606.1555. (Monday to Friday, 8:30 AM - 5:00 PM, ET)

If you would like to receive the names of physicians who best meet your individual needs via email, please complete the following form.
This question requires a valid date format of MM/DD/YYYY.
calendar
Is there a specific physician you would like to see? *This question is required.
Do you have a prescription for physical therapy? *This question is required.
Insurance
In addition to physicians in your network, would you also like to consider physicians who are out of network?
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