Intake & New Patient Forms

Please complete the following forms and either email them back to us completed, or bring them completed to your appointment. This will save you time at your appointment and keep your appointment from being delayed.

To complete using Microsoft Word (complete on your computer, save and email back to us) download the following:

Notification of Privacy

Patient Intake Form

PMHx Form

To download a PDF version of the above forms to print, fill in and bring to your appointment click the following link:

Intake Forms

 

Please download and read the following at your convenience regarding Privacy Laws:

Privacy Information
 

Participating Insurance Carriers

Chittenango Physical Therapy participates with the following insurance companies:
  Aetna*
Blue Cross Blue Shield*
CDPHP*
Cigna*
Empire/MPN
GHI*
Great West
Health Now
Medicare		 MVP Health Plan
North American Preferred
PHCS/ Statewide Independent PPO, Inc
POMCO
RMSCO
Tricare Standard*
United Healthcare
Worker's Compensation*
No Fault
 

*These insurances require preauthorization. We can contact your insurance company for preauthorization. In the unusual case where an insurance company will not allow us to preauthorize, we can contact your Doctor directly.

We will see patients within 48 hours or even the same day if possible.
 
Chittenango Physical Therapy
239 Genesee Street, Suite 1 • Chittenango, NY 13037 • (315) 510-3372 • F-(315) 510-3688
 

Announcements

Chittenango Physical Therapy Opens
Hand Therapy Program!

Jean Kernan Francisco OTL, CHT has joined the staff at Chittenango Physical Therapy as director of the Hand Therapy Program.  She is a licensed occupational therapist with a certification in hand therapy. Our Hand Therapy Program offers rehabilitation of patients with a wide variety of traumatic injuries and chronic conditions of the hand, wrist, arm, elbow, and shoulder.

Tim Francisco, PT, OCS, CSCS obtains his Board certification in Orthopedic PT

Alyssa Kurtzner obtains her doctorate in PT and joins the CPT team

 

  
     

 

 

Hours of Operation:

Mon., Wed., Thurs., Fri.
7 a.m. - 7:30 p.m.

Tues. 7 a.m.- 5 p.m.