Patient Forms & Documents | LifeCare Works

Patient

Forms & Documents

PATIENT FORMS

About

Electronic forms are forms that can be completed (including signature) online. All forms are also available in print version. Please select the form and link that you need.

Intake Package

Forms required to be completed by the first therapist to see the patient. Forms must be signed prior to SOC.

Electronic Link

Print Version

Getting Started with LifeCare

An overview of the process from evaluation - discharge for patients.

Electronic Link

Print Version

NonCompliance with Therapy

A letter to inform patients that they will be discharged if cancellations occur.

Print Only

Print Version

Treatment Verification Log

To be used when HUCU check-in/check-out is not available

Electronic Link

Print Version

Authorization for Release of PHI

When patient requests records release

Electronic Link

Print Version

Hardship Letter

Office will advise if needed.

Electronic Link

Print Version

Care After Therapy

Letter to provide to patients at discharge about treatment options

Electronic Link

Print Version

Fitness Plus Waiver

Waiver for private pay services

Electronic Link

Print Version

INFORMATIONAL HANDOUTS

Theraband

Biofreeze

General Exercise Precautions

TESTS & TOOLS

SLUMS

High Amplitude Exercises for PD (Patient Handout)