Active Physical Therapy & Wellness - Orthopedic Physical Therapy Services for All Ages

FORM DOWNLOADS

Medical History 1

Medical History 2

Med History Current Symptoms

Insurance Information Form

Disclosure Statement

New Patient Info & Forms

Please Note : In the state of Michigan, a physician referral is required for physical therapy. Please contact Active Physical Therapy and Wellness for details regarding this issue.

What to bring for your first visit
Please be sure to bring your drivers license, insurance card and your referral form from your physician.

Most insurance plans accepted including

	ACS Federal Workers Comp Aetna Auto Blue Care Network Blue Cross Blue Shield of MI Blue Cross Blue Shield of MI Medicare Advantage Cigna Empire Blue Cross Blue Shield (Orthonet) Health Alliance Plan (HAP) HAP Preferred, HAP HMO, HAP Medicare Advantage Health Plus of Michigan HealthPlus PPO HealthPlus Senior (Medicare Advantage) McLaren Health Advantage Medicaid (secondary) not primary Medicaid HMO’S: Health Plan of MI HealthPlus Partners McLaren Health Plan Molina Healthcare Total Health Care Medicare Medicare Railroad PPOM (Advantus) Cofinity Tricare (Healthnet)- Standard, Prime Network United Healthcare ACN (OptumHealth) Workers Compensation