Online Forms

For your convenience, APT Plus will be posting electronic versions of some of its forms and paperwork for you to fill out and submit one of 3 ways.

First Time Visit Form More Forms Coming Soon!  
  1. The first way to submit the forms would be to either fill the form out on your computer, print the forms out on your printer, and bring them in with you on your next visit. We will then look the form over to make sure all relevant information is filled out and the form can then be signed and dated.
  2. You may also fill the form out on your computer, print it out, and fax it to (219) 864-2567. We will then look the form over to make sure all relevant information is filled out and the form can then be signed and dated.
  3. The third way to fill out the form would be to fill out the form on your computer, and in the upper right corner of the form will be a button labeled 'Submit by Email'. Clicking the button will open a small dialog box asking you what type of email you use.
    1.  If you use an email client like Outlook, Outlook Express, Thunderbird, or Eudora, choose the first option and click 'Next'. A compose new message box will appear with your completed form attached. Change the 'Subject' field to "Your Full Name - First Time Visit Form" Type a quick message with your Full Name, a phone number where we can easily reach you, and days and times which you would be able to come in for an appointment, and send the email.
    2. If you use Yahoo Mail, Gmail, Hotmail, Comcast, or any other online web email, select the second option and click 'Next'. A 'Save File As' dialog box will appear. Save the file in a place you can easily remember to get to such as 'My Documents' or 'Desktop' and save the file as Your Full Name.xml. Once the file is saved, open you online email program, attach the saved file, and send the email and file to dyerfd@physicaltherapynow.com with the 'Subject' of "Your Full Name - First Time Visit Form". Type a quick message with your Full Name, a phone number where we can easily reach you, and days and times which you would be able to come in for an appointment, and then send the email.

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