Physical Therapy Referral Form

An intuitive and effective physical therapy referral form will help you improve communication, automate referrals, and ensure your patients receive the highest quality of care.

By Bernard Ramirez on Mar 06, 2024.

Fact Checked by Ericka Pingol.

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What is a Physical Therapy Referral Form?

Often when patients are receiving treatment, their primary care physician will refer them to a different practitioner. Referrals occur for a number of different reasons, one of the most significant of which is enabling patients to receive specialized care from a range of different practitioners. The network of referred specialists that a physician belongs to is an important component of working in healthcare: it establishes professional relationships and ensures patients have access to the care that they require. The referral process should be both easy and seamless, yet without the right resources, it can become unnecessarily complicated. For this reason, we have designed a that practitioners can utilize when they are referring their patients to a physical therapist. This resource will automate the referral process and improve communication between the referring and referred physicians. It can be used by any practitioner who is referring their patient to a physical therapist and as such, is both highly versatile and effective.

Printable Physical Therapy Referral Form

Download these physical therapy referral forms to track your client's treatment progress and therapy outcomes.

How to Use This Template for Physical Therapy Referral Form Template

Fortunately, implementing the physical therapy referral form template into your practice is very simple. In order to maximize your use of this resource, you just need to follow these steps:

Step One: Download the referral form

On this page, we have included a link to the referral form template. If you click on this the template will open in a PDF reader on your device, and from there you can save the document. This will allow you easy access to the form whenever you may need it. 

Step Two: Complete the form

When you are treating a patient that requires care from a physical therapist, it’s time to use the referral form. If you have downloaded it onto your device then it should be easily accessible with a few simple clicks. During your session with a client, you should complete the relevant sections before giving a copy to the client. 

Step Three: The patient takes it to the referred physical therapist

After you ave completed the form and given a copy to your patient, they can then take it to the relevant physical therapist. The referral form provides the physical therapist with all of the information they need to treat the patient appropriately, which in turn should improve clinical outcomes and streamline coordination of care.

Step Four: Store the form securely

If you have held onto your own copy of the referral form for documentation purposes, you need to ensure it is stored securely. Referral forms contain confidential information regarding the patient’s personal and medical details and as such, it is protected by HIPAA. You can choose to either store the form in a physical location (like a securely locked filing cabinet) or online, where it can be protected by electronic safeguards.

Physical Therapy Referral Form Example (Sample)

Sometimes the best way to visualize what a resource looks like is to see it in action. This is why we have created a sample physical therapy referral form. The example is based on an appointment that a patient has with their primary care physician, who has decided to refer them to a physical therapist. While the specific details included in this sample will differ from yours, it should give you a good insight into how the referral form will work, and what it looks like.

Download this Physical Therapy Referral Example (Sample) here: 

Physical Therapy Referral Form Example (Sample)

Who Can Use this Printable Physical Therapy Referral Form (PDF)?

Healthcare is broad, and it’s important that resources used at your practice are applicable to a range of different practitioners and patients. This referral form template has been primarily designed to be used by physicians who refer their patients to physical therapists, but the referring practitioner may work in a range of different healthcare fields, including:

  1. General Practitioner
  2. Occupational Therapy
  3. Chiropractor
  4. Massage Therapy
  5. Sports Physician 
  6. Orthopedic Surgery

Why is This Form Useful for Physical Therapists?

One of the best aspects of our physical therapy referral form is how diverse it is in its usefulness. If you implement this resource into your practice, you will benefit from its various uses, which include the following:

Automate referrals: The referral form is highly effective in automating the referral process. Instead of having to play phone tag with administrative staff and the referred physician, you can use this one simple form to communicate all important information. With this document, the referral process becomes much more efficient, and patients can quickly and easily access the care they need.

Organization: Using a referral form template will also elevate the organization at your healthcare practice. Staying on top of your documents and ensuring they are accessible and stored securely has never been easier with this referral form, and you can deliver quality care solutions to your patients while also focusing on your own organization. 

Accurate data: This referral form template also helps ensure the data you collect is accurate. The form is separated into the different relevant sections, ensuring you obtain all of the information required to treat the patient appropriately.

Physical Therapy Software Feedback

Why Use Carepatron For Physical Therapy Referral Form Software?

Using state-of-the-art software like Carepatron is one of the best decisions your practice can make if it is looking to optimize its referral process. Carepatron is integrated with a range of different robust tools, including this physical therapy referral form. The system allows practices to save, share, and store documents, ensuring that this referral form is easily accessible. Taking HIPAA-compliance very seriously, Carepatron has sophisticated electronic and physical safeguards in place, guaranteeing the 24/7 protection of patient privacy. In addition to this template, Carepatron also offers a secure patient portal where clients can view appointment and payment information. Perhaps more importantly, this portal can also be used as a secure messaging channel between patients and practitioners, ensuring that communication is effective and documents can be transferred securely. As you can see, Carepatron has all of the tools required for a smooth and seamless referral process. With additional clinical documentation, appointment scheduling, mobile health, and medical billing features, Carepatron is the perfect solution for any healthcare practice looking to optimize its clinical and administrative processes.

Physical Therapy Software
Why are physical therapy referral forms done?
Why are physical therapy referral forms done?

Commonly asked questions

Why are physical therapy referral forms done?

There are a number of reasons why physical therapy referral forms are done. Firstly, they ensure that the referred therapist has access to all of the information they need to treat a patient appropriately. While this process can be completed through a phone conversation or remote messaging, using a form is more efficient and time-effective. Physical therapy referral forms also enable patients to have their sessions covered by insurance, as many providers require referrals in order for coverage to be applied.

When do you complete a physical therapy referral form?

Physical therapy referral forms need to be completed when you refer a patient to a physical therapist. It is usually the case that this will occur during a session with a patient, so you can complete the form and give them a copy.

Do you need a referral to see a physical therapist?

While the specific regulations regarding who can see a physical therapist and whether this is covered by insurance will depend on the state in which you reside, generally you don’t need a referral. If the patient knows that they need to see a physical therapist and they have a specific practice in mind, then they can skip the referral process and book an appointment.

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