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Patient Forms

You may download the necessary forms through the links listed below. They will download as an Adobe Acrobat Reader PDF file containing the pages of forms you need to complete before you come in for your first visit. Please print out all the pages and bring them with you. You may also scan and email completed forms to: envisionphysicaltherapy@yahoo.com

Envision Physical Therapy Pediatric
(2-5 years of age) Intake Form.pdf

   Envision Physical Therapy
Self-Pay/Cash Intake Form.pdf

Envisions Physical Therapy
       HIPAA Form.pdf

Envision Physical Therapy Medicare
             Intake Form.pdf

  Envision Physical Therapy Major
Medical Insurance Intake Form.pdf

Envision Physical Therapy Workman's                     Comp Intake Form.pdf

Envision Physical Therapy Auto Accident-                Personal Injury Intake Form.pdf

Envision Physical Therapy              No Surprises List

  Dr Mark Harris MVA Harris Chiropractic
                Clinic Intake Form

     Dr Mark Harris MVA Harris Chiropractic                Clinic Major Medical Intake Form

Dr Melanie Cross, Lake Mary Medical Services
                         Pain Management Forms

 Dr Melanie Cross Lake Mary Medical Services
        Pain Management Intake Form.pdf

   Dr Melanie Cross Lake Mary Medical Services
  Auto Accident - Personal Injury Intake Form.pdf

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Auto Accident -Personal Injury Intake Form.pdf
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CLICK ON THE LOGO TO VISIT 

Give Us  A Call To Request                 An Appointment

     PHONE: 407.936.0314  FAX: 407.936.0316
    EMAIL: Envisionphysicaltherapy@Yahoo.com

We hope to be your first choice for physical therapy in the Lake Mary area. With our advanced experience and commitment to personalized care, we are able to deliver the most positive and enriching physical therapy experience to ensure ultimate results. You get better faster and get back to the activities you love Pain Free! 

LAKE MARY LOCATION:
956 INTERNATIONAL PARKWAY,
SUITE 1580

LAKE MARY, FL 32746

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CENTRAL PARC AT HEATHROW

PLAZA BEHIND STARBUCKS AND

ANOTHER BROKEN EGG CAFE.

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HOURS OF OPERATION:
  •  Monday: 7am-7pm
  •  Tuesday: by appointment only 

  •  Wednesday: 7am-7pm

  •  Thursday: 9am - 2pm

  •  Friday: 7am-5pm

  •  Closed: Saturday & Sunday 

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Spanish Speaking Available and Notary Services Available

MOVE BETTER!

FEEL BETTER!

LIVE BETTER!

At Envision we understand the importance of quality. We are proud to partner with the following companies to offer you a wide range of services to meet your health and wellness goals.

All patients are treated by a licensed DC, DPT or a PTA

AHCA LIC 8405

MASSAGE EST LIC MM22492

Our Partners

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Jenny Paulston

Local Life Insurance Agent

386.898.3344

Jennyp.sfg@gmail.com

NPN #20650197

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Melanie Cross M.D.

407.721.2127

lakemarymedicalseervices@yahoo.com

https://www.lakemarymedicalservices.com

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Avalon Hypnosis

407-492-7363

http://www.AvalonHypnosis.com

956 INTERNATIONAL PARKWAY,
SUITE 1580

LAKE MARY, FL 32746

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© 2018 by Envision Physical Therapy. Proudly created by BARFLY GRAPHICS 2021

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