Forms

window1All patients need to fill out the following new patient paperwork before we can begin your first appointment. For your convenience, we’ve updated our forms so that you can fill them out within Adobe Acrobat. You can then print these forms out and bring them in with you, or email them to us ahead of time to: kylie@befit-pt.com

Additional forms you may need to fill out if you are being seen for:

If you are covered by the Dartmouth Student Group Health Plan (DSGHP – HealthSmart) through Dartmouth College please complete the attached form and review the expected out of pocket coverage information here.

(Updated February 2018)

45 Lyme Road, Suite 101
Hanover, NH 03755


100 Arboretum Lane
White River Junction, VT 05001
Barlow - Ellingson
Sports and Orthopedic
Rehabilitation
HANOVER:
tel: 603-653-0040
fax: 603-653-0041
email: kylie@befit-pt.com


WRJ:
tel: 802 359-7400
fax: 603-653-0041
email: sandy@befit-pt.com
Copyright 2017 BE Fit Physical Therapy. All Rights Reserved.