Patient Forms & Insurance

Patient Forms

At Virginia Center for Spine & Sports Therapy, we want to maximize your time with us. Prior to your first visit, please print and fill out the new patient forms below. Please bring these with you to your first visit along with your insurance information and photo ID. There may be additional forms specific to your condition or insurance that we will give you when you arrive for your first appointment.


If you are unable to print or complete your paperwork prior to arrival, please arrive 20 minutes before your scheduled evaluation time.

At your first appointment, please bring:

  • Your completed paperwork
  • Your insurance card(s)
  • A photo ID
  • A list of all your medications with dosages (we can make a copy of this if you prefer)
  • Your prescription for PT (if you have one)


Insurance Information

We gladly accept most the insurance plans. Please call us to confirm your insurance. We are always adding new insurance plans.

As a courtesy to our patients, we will verify your health benefits prior to your arrival to determine if there will be a copay, deductible, or coinsurance for therapy services.

For those patients who do not have health insurance or those who have maxed out their benefits, we offer a private pay plan. Please contact us at Midlothian, VA center today for more information on our fees for service and payment details.

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