Perry Physical Therapy
  • Home
  • About
    • Our Staff
    • Office Forms and Services Pricing
    • Related Links
  • Techniques
    • Strain & Counterstrain >
      • Fascial Musculoskeletal Strain & Counterstrain
      • Lymphatic Counterstrain
      • Viscera Counterstrain
      • Arterial Counterstrain
      • Cranial Counterstrain
      • Neuro Counterstrain
    • Visceral Manipulation
    • Joint Mobilizations
    • Myofascial Release
    • Muscle Energy Technique
    • Medical Fitness
    • Physical Therapy Modalities
  • Contact
  • Testimonials
  • Home
  • About
    • Our Staff
    • Office Forms and Services Pricing
    • Related Links
  • Techniques
    • Strain & Counterstrain >
      • Fascial Musculoskeletal Strain & Counterstrain
      • Lymphatic Counterstrain
      • Viscera Counterstrain
      • Arterial Counterstrain
      • Cranial Counterstrain
      • Neuro Counterstrain
    • Visceral Manipulation
    • Joint Mobilizations
    • Myofascial Release
    • Muscle Energy Technique
    • Medical Fitness
    • Physical Therapy Modalities
  • Contact
  • Testimonials
Search by typing & pressing enter

YOUR CART

Office Forms and Services Pricing

Want to save time during your initial office visit?  Download, print, and fill out the forms for your specific needs below.
New Medicare Patients
Please print and fill out forms 1-4 below.
1. New Patient Form
File Size: 1011 kb
File Type: pdf
Download File

2. Office Policy
File Size: 35 kb
File Type: docx
Download File

3. Privacy Notice
File Size: 100 kb
File Type: doc
Download File

4. Medicare Exclusions
File Size: 53 kb
File Type: docx
Download File

5. Medication List
File Size: 79 kb
File Type: docx
Download File

6. Medicare Questionaire
File Size: 533 kb
File Type: pdf
Download File

7. Patient History Form
File Size: 89 kb
File Type: pdf
Download File

New Private and Workers' Compensation Patients
Please print and fill out forms 1-3 below.
1. New Patient Form
File Size: 1011 kb
File Type: pdf
Download File

4. Patient History Form
File Size: 89 kb
File Type: pdf
Download File

2. Office Policy
File Size: 35 kb
File Type: docx
Download File

3. Privacy Notice
File Size: 100 kb
File Type: doc
Download File

New Cash Pay Massage and Bodywork Patients
​
Please print and fill out forms 1-3 below.
1. New Patient Form
File Size: 1011 kb
File Type: pdf
Download File

2. Cash Pay Billing Policy
File Size: 128 kb
File Type: pdf
Download File

3. Treatment Waiver
File Size: 68 kb
File Type: docx
Download File

Cash Pay Services Offered and Pricing Breakdown
Physical Therapy Evaluation With Treatment (Out of Pocket)
    - $190 for One Hour Session Including manual therapy, Exercise and modalities as needed
    - $100 to $150 for Follow-up Session (30-45 minutes)
Personal Training & Exercise Instruction Only​
    - 
​$120 for One Session (45-60 Min.) or One Time
    Home Exercise Program


Electrical Stimulation and Modalities Only
    
- $ 50 Per Session (15-30 Min.)


​

44025 Jefferson St., Ste 104
La Quinta, CA 92253
Phone: (760) 345-5453
Fax: (760) 345-7063
Hours of Operation:
Mon - Thurs 7:30am - 6:00pm
Closed weekends and major holidays
Proudly powered by Weebly