Lake Centre for Rehab

Forms

We want you to have an excellent first visit experience so please download the patient forms and have them filled out prior to your first visit. You will need adobe reader to download the forms. If you don’t have adobe reader, please click here: Adobe Reader

new patient forms

male pelvic floor patient forms

female pelvic floor patient forms

If you feel you could benefit from one of our therapy services, download the Patient Referral Form, bring it with you when you visit your doctor to discuss your course of action!

On your first visit, please remember to:

  1. Bring Physician or NPP (Non-Physician Provider) order for therapy
  2. Bring Insurance cards (primary and secondary)
  3. Bring a Photo ID
  4. Bring a current list of medicines and allergies
  5. Bring recent reports that you might have, including x-rays, MRI’s, surgeries, etc.
  6. Bring in any adaptive devices currently used, such as braces, canes, walkers, etc.
  7. Bring a copy of home health discharge with name and phone number of home health agency if applicable
  8. Wear Loose-fitting, comfortable clothing
  9. Wear Supportive closed-toe shoes.
  10. Notify us of implants and pacemakers (defibrillators)

 

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Lake Centre for Rehab Offices will be closed Friday, October 7

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Due to Hurricane Matthew all 7 Offices in Lake, Sumter and Marion County will be closed.

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