Sincerely,
Dr. Kerry
Medicare Intake Form
Auto Accident Intake Form
Private Insurance Intake Form
Remote Session Intake Forms
Completed Intake Forms: If you have not already done so, please download and complete the necessary intake forms before your appointment. These forms will help us gather valuable information about your medical history and specific concerns.
Prescription for Physical Therapy and/or Acupuncture: If you have a prescription or referral for physical therapy and/or acupuncture, please bring it to your appointment.
Relevant Imaging: Please bring the reports or images if you have had any recent X-rays, MRIs, CT scans, or other imaging studies related to your condition. These can provide valuable insights for our evaluation.
Relevant Special Tests: Please bring the results or reports if you have undergone any specialized tests or procedures relevant to your condition, such as nerve conduction studies or electromyography (EMG). These can provide valuable insights for our evaluation.
Current Medication List: We need to know your current medications. Please list your current medications, including any over-the-counter drugs or supplements.
Comfortable, Loose-Fitting Clothing: We recommend wearing comfortable, loose-fitting clothing that will allow for ease of movement during the evaluation and treatment process. If needed, gowns are available for your comfort and privacy.
During your initial visit, we will spend approximately 60-75 minutes conducting a comprehensive evaluation to assess your condition and understand your needs. Based on our findings, we will perform the following:
Discuss our findings with you and explain the recommended treatment plan in detail
Develop a personalized treatment plan designed to address your concerns and help you achieve your goals
Provide a concise summary of our evaluation findings and the proposed treatment plan to your referring provider (if appropriate)
Ensure that all healthcare team members are aligned and working together to support your well-being
Please do not hesitate to ask if you have any questions or need further clarification about the evaluation process or treatment plan. We are here to guide you on your journey towards better health.
Our team is dedicated to helping you navigate the insurance process to ensure you receive the maximum benefit from your insurance company. We will guide you through the necessary procedures and provide support to help you understand your coverage. We accept the following insurance plans:
Private Health Insurance: Individual health plans have different requirements. You should contact your health plan to determine your eligibility benefits or provide us with the details so we can.
Medicare: Medicare requires an evaluation and referral by a primary care physician before your initial visit to our office and every 30 days or ten visits while having physical therapy. Our office staff will file your Medicare Claims and Supplemental Insurance and send your physician updates on your progress.
Auto Accident Claims: Auto claims require an evaluation and referral by an Approved Medical Provider within 14 days of the accident date. The referral prescription must say, "Evaluate and treat an emergency medical condition." If your coverage includes PIP and Med pay, there is no additional cost to you. If your coverage only includes PIP, you will be responsible for the 20% they do not cover at the time of service. If your health insurance covers the additional 20%, we will file this claim for you, and payment depends on your particular deductible.
LOCATION
Therapeutic Systems Incorporated (TSI)7311 Merchant Court Sarasota, Florida, 34202USA
CONTACT
Main: 941.907.9250Fax: 941.907.8280
Email: ?
HOURS OF OPERATION
Monday through Friday
9:00 AM to 5:00 PM
By Appointment Only