Forms & Insurance

Patient Forms and Insurance Information

VIP Rehab accepts most all insurance providers including Blue Cross/Blue Shield, Blue Cross/Blue Shield Workman's Comp, Tri-Care, Acclaim, Medicare.

As a courtesy for our patients we will contact your insurance carrier to determine your benefits for physical or occupational therapy and submit all claims to your carrier.

If you have questions about your individual insurance coverage please contact us and we will be happy to find the answers for you.

For those uninsured patients, VIP Rehab will work with you to acheive an affordable plan for your therapy services.

Patient Forms

Want to save time in our office? Take a moment to print and complete the forms below. Then bring them in for your first visit!
Patient Intake & Consent Form
Medicare Secondary Payer Questionnaire
Confidence Baseline Form
Difficulty Baseline Form

Your appointment is just a call away!