Patient Resources

Get Started with In Home Therapy!

Welcome to the Patient Resources page for Custom Care Rehab. To help you get started with your in-home physical therapy program, please complete your patient forms before your evaluation.

You will be receiving electronic documents from HelloNote on behalf of Custom Care Rehab. Please fill out these medical forms before your scheduled appointment. Completing these treatment forms ahead of time helps your therapist prepare for your evaluation and ensures a smooth start to your care.

If you have questions about your in-home physical therapy sessions or additional physical therapy resources, please reach out to our team anytime.

If you cannot receive electronic paperwork, please, download and fill out the:

1.) 1st two pages of the  Notice of Privacy

2.) HIPAA

3.) Patient Intake Form

If you cannot receive electronic documents, you are welcome to download your physical therapy resources directly from this page, fill them out, and your therapist will collect the papers on the day of the evaluation.

1.

Notice of Privacy Practices

2.

HIPAA

3.

Patient Intake Form

Additional Forms

Insurance Form
No Suprise Billing Form
Custom Care Rehab Policies and Procedures
Credit Card Authorization
Out of Network Tips
Medical Release Forms