Intake Forms - Physical Therapy

193 N. Wellwood Ave. Lindenhurst, NY

Child Intake Forms for parental consent.

Intention to use Major Medical Insurance.

Form for those that do not have insurance.

Form for workers compensation, patients who where hurt on the job.

Form for no-fault Insurance for auto accidents.

For patients who will only see PT and no Chiropractor.

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Dr. Cullin and our team of individually licensed practitioners use a multi specialty approach to treating patients at our clinic.

193 N Wellwood Ave
Lindenhurst, NY 11757

Mon-Thurs: 9am-12pm, 3pm-7pm
Friday: 9am-12pm
Saturday: By Appointment Only