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12581 Milstead Way #201, Woodbridge, VA 22192 (703) 763-3922
Mid-County Physical TherapyMid-County Physical Therapy
  • Solutions
    • Athletic Injury Program
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      Athletic Injury Program

      We are experts in treating adolescent sports injuries effectively, efficiently, and conservatively without medications, side effects, or invasive procedures.

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      neck-back-physical-therapy

      Neck & Back Program

      As experts in relieving Neck and Back pain we address the root causes rather than merely treat the symptoms. This results in a longer-lasting relief and is highly effective in preventing a recurrent problem.

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      joint-replacement-program

      Joint Replacement Program

      Our treatment protocols facilitate full recovery, promote proper healing, and protect appropriate structures from harmful stress.

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      triggerpoint-dry-needling

      Trigger Point Dry Needling

      Manual Trigger Point Dry Needling is a hands-on Physical Therapy approach to treat myofascial pain and dysfunction.

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      red-light-therapy

      BioQpulse and Redlight Therapy

      This amazing treatment is great for those who may be suffering from pain caused by back problems, digestion disorders, cramps and pelvic floor issues and much more!

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      830 Laser Program

      The revolutionary 830laser is stopping pain around the world.

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      VIEW ALL SOLUTIONS
    • Neck & Back Program
    • Joint Replacement Program
    • Trigger Point Dry Needling
    • BioQpulse and Redlight Therapy
    • 830Laser Program
  • Ailments We Treat
    • Ankle & Foot Pain
    • Elbow Pain
      foot-ankle-pain

      Ankle & Foot Pain

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      elbow-pain

      Elbow Pain

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      lower-back-pain

      Lower Back Pain

      LEARN MORE

      hip-thigh-pain

      Hip & Thigh Pain

      LEARN MORE

      head-neck-pain

      Head & Neck Pain

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      knee-pain

      Knee Pain

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      shin-splints

      Shin & Calf Pain

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      VIEW ALL AILMENTS
    • Head & Neck Pain
    • Hip & Thigh Pain
    • Knee Pain
    • Lower Back Pain
    • Shin & Calf Pain
  • About Us
    • Why Choose Us
    • Our Staff
    • Contact Us
  • Resources
    • Insurance/Pricing
    • Forms
    • Testimonials
    • Blog
  • (703) 763-3922
  • Make an Appointment
Search for:
  • Solutions
    • Athletic Injury Program
    • Neck & Back Program
    • Joint Replacement Program
    • Trigger Point Dry Needling
    • BioQpulse and Redlight Therapy
    • 830Laser Program
  • Ailments We Treat
    • Ankle & Foot Pain
    • Elbow Pain
    • Head & Neck Pain
    • Hip & Thigh Pain
    • Knee Pain
    • Lower Back Pain
    • Shin & Calf Pain
  • About Us
    • Why Choose Us
    • Our Staff
    • Contact Us
  • Resources
    • Insurance/Pricing
    • Forms
    • Testimonials
    • Blog
  • (703) 763-3922
  • Make an Appointment

Home » Resources » Forms

Forms

We make it easy for you to register for care by having you complete a minimum amount of paperwork. Please complete and bring the following forms with you on your first visit.

  • Express Registration Form
  • Pre-Exam Form
  • Pre-Exam Form – Post Op Patients
  • Medicare Secondary Payer Questionnaire – Medicare Patients Only
  • Assignment of Benefits Form
  • Consent for Treatment Form
  • Pain Diagram Form
  • Outpatient Medical History
  • Notice of Privacy Practices
  • Medical Information Release Authorization

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OUR SERVICES

  • Athletic Injury Program
  • Neck & Back Program
  • Trigger Point Dry Needling
  • Joint Replacement Program
  • BioQpulse and Redlight Therapy
  • 830Laser Program
Menu
  • Athletic Injury Program
  • Neck & Back Program
  • Trigger Point Dry Needling
  • Joint Replacement Program
  • BioQpulse and Redlight Therapy
  • 830Laser Program

Ailments We Treat

  • Ankle & Foot Pain
  • Elbow Pain
  • Lower Back Pain
  • Knee Pain
  • Head & Neck Pain
  • Hip & Thigh Pain
  • Shin & Calf Pain
Menu
  • Ankle & Foot Pain
  • Elbow Pain
  • Lower Back Pain
  • Knee Pain
  • Head & Neck Pain
  • Hip & Thigh Pain
  • Shin & Calf Pain

About Us

  • Why Choose Us
  • Our Staff
  • Contact Us
  • Blog
  • Insurance/Pricing
  • Forms
  • Testimonials
Menu
  • Why Choose Us
  • Our Staff
  • Contact Us
  • Blog
  • Insurance/Pricing
  • Forms
  • Testimonials
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OUR Location

12581 Milstead Way #201, Woodbridge, VA 22192

Phone

(703) 763-3922

Connect With Us

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Facebook
Youtube
Linkedin
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