In order to verify the
benefits available to you under your insurance policy, we need to get
some information about your plan. Once we have this information we can
proceed with the scheduling of appointments. If you do not want to use
your insurance benefits, and choose to pay for the treatment yourself,
you can be scheduled as soon as we recieve this information.
Please click on the link below to print out the patient form. This form
can be used in two ways:
1. Print out the form, complete it, and fax it to us at 303.996.0390
2. Obtain the necessary information to complete the form and call us at
303.832.5577 and you can give us the information personally.
Please be sure to complete every line of the patient information section.
Your insurance company will need this to verify benefits. The telephone
number for the insurance company is very important and can usually be
found on the back of your insurance card.
If you have any further questions, please feel free to contact us by phone
at 303.832.5577 or email us directly at administration@backtomotion.net
Welcome
Forms
Discharge Forms in Adobe Acrobat Format
I received high quality care with easy to follow instructions for my home exercises. My condition improved steadily and today I am pain free and I received a plan to follow at home to insure that I stay that way.
--Christopher