We love helping people achieve relief from pain and reach their full potential, thus making a difference in their lives. Who do you know that needs our help? Simply fill in the form below and we will send them information about how we can help. We will gladly answer any questions they may have about their condition and how we can help. They will thank you and so will we!

REFERRAL INFORMATION

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CONTACT US

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At Flat Rock Physical Therapy for Pain, we want to maximize your time with us. Prior to your first visit, please fill out the new patient form below and submit it. Also bring along proof of ID along with your insurance information. PRIVACY STATEMENTPlease note that no personal information from this form will be stored on our website database. All information is securely directed and saved in our clinic’s Electronic Medical Record (EMR) system where all data is encrypted. The patient information will only be used by the clinic and will not be passed on to any third party.