top of page

New Patient Intake Form

If you're a new patient at San Clemente Physical Therapy you can download, print, and fill out the following form prior to your first visit to help expedite the intake process.

Please remember to bring a photo identification (Driver's Licence), copy of insurance card, and a copy of your prescription.

To schedule an appointment with our office please call (949) 240-0600.

laura@scpt.occoxmail.com

(949) 240-0600

FAX (949) 240-7578

647 Camino De Los Mares

Suite #111

San Clemente, CA 92673

©2018 BY SAN CLEMENTE PHYSICAL THERAPY. 

bottom of page