Patient Info / Forms

We are here to help you enjoy your life, pain-free! To make a convenient appointment, simply call us today at 413.586.5552. Our practice is dedicated to helping our patients identify the cause of their pain and creating a custom treatment program that will allow them to return to normal activities pain-free.

Patient Forms

At Aegis Chiropractic & Physical Therapy, we want to maximize your time with us. Prior to your first visit, click here to complete the New Patient Registration Form online.

If you would prefer to download a PDF, you can do that instead. Bring the forms with you to your first visit along with your insurance information.

You may also download and sign Notice of Privacy Practices about restrictions and disclosures of your health information.

1New Patient Form

New Patient Form

2Cancellation Policy

Cancellation Policy

3Notice of Privacy Practices

Notice of Privacy Practices

Before Your First Visit

  • Make a list of questions that you have to discuss on your first visit.
  • List signs and symptoms that can be of importance to the physical therapist.
  • Have in writing key past medical history, previous treatments, current medications, and other important information.
  • Please call our office to verify your insurance benefits.
  • Arrive 15 minutes early for your first appointment.
  • Bring with you a copy of your insurance card.

Co-Pay & Cancellation Policy

Co-pays are per visit and are due at the time of each appointment. Our front office staff will do their best to help you understand your payments. However, it is the patient’s responsibility to know what their insurance coverage is. Aegis Chiropractic & Physical Therapy is NOT responsible for any inaccurate estimates made. 

WE REQUIRE 24-HOUR NOTIFICATION FOR APPOINTMENT CANCELLATIONS

At Aegis Chiropractic & Physical Therapy we are proud of our one-on-one treatment approach; we never double-book patients. This approach allows our patients to have the Therapist’s constant undivided attention. With proper notification, most canceled appointments can be easily filled. However, with less than 24 hours notice it is difficult to fill the vacant time slots created by cancellations. 

We assess a $25 fee for appointments canceled with less than 24 hours notice. Any appointment that is not canceled and you do not show up for will be charged $60. Patients who miss appointments or cancel with less than 24 hours notice three (3) times will have their future visits removed and will not be allowed to schedule ahead. Those patients may call on any day to see if there are available times slots with their Therapist. 

We never penalize cancellations with more than 24 hours notice.

Motor Vehicle and Workman’s Compensation patients will be personally responsible to pay the late cancellation and no show fees. 

We appreciate your cooperation. 

What to Expect on Your First Visit

  • Paperwork – Plan to arrive 10-15 minutes before your scheduled appointment in order to complete the necessary paperwork. (Or you can print out the forms and bring them in already filled out.)
  • What To Bring – Please bring your insurance card, the referral or prescription from your doctor (if you have one for this injury), any relevant medical reports you might have (such as an MRI report), and comfortable clothing to move around in (T-shirt or tank top for upper body injuries, shorts for lower body injuries).
  • Length of Appointment – First appointment is 1 hour.
  • The Consultation & Examination – Your physical therapist will review your paperwork and discuss your injury and symptoms with you to get background information. He or she will then assess the way you move, the way you walk, your posture, your strength, your flexibility and more in order to determine the problem areas and the necessary solutions.
  • The Treatment – In most cases, treatment will begin immediately, which may include hands-on techniques and/or specific exercises. Most likely, your physical therapist will instruct you in a home exercise program with a few important things that you can start doing on your own at home to reinforce the long-term treatment plan.

Get started on your recovery, Today!