Meadowlands Physiotherapy Patient Consent Form and Physiotherapy Intake Sheet
Upon completion of your assessment, the Physiotherapist will discuss the specific treatment plan recommended for you. You will receive a Personalized Treatment Plan outlining a recommended program of care for your injury/condition. Any complications or side effects of the proposed treatment will be discussed with you by the Physiotherapist
Please be advised that we require a minimum of 24 business hours to cancel an appointment or a missed appointment fee may be applied.
I have read and understood the above policies and agree to abide by these conditions. I agree to a Physiotherapy Assessment and Treatment to be carried out by a Registered Physiotherapist. I agree to
pay for all services rendered.
I understand that Meadowlands Physiotherapy will keep all medical records confidential and these will not be released without my written consent to anyone other than those mentioned below, except where required by law.