Physical therapy information

Patient/CLient forms

Please call and schedule an appointment - 813.803.7070

Can be downloaded and printed or emailed to

Schedule an Appointment

To schedule a patient/client appointment, please call 813.803.7070

To save time when coming to our office for your first appointment - 

Physical Therapy Patients will need to take the time to fill out in full your new patient forms and medical history. Accurate and complete information is critical to your care, and best assists your health care provider in coming up with the most effective treatment plan for your condition.  Please bring a form of ID, insurance card (if applicable), diagnostic reports, x-rays, and prescription information from your physician, if possible.  


If you have not completed your forms in advance, please arrive 15 minutes prior to your scheduled appointment time to prevent shortened treatment time. Otherwise, arrive at least 5 minutes before your appointment start time.

What you need to do

  • Please complete the patient registration forms prior to coming in for your first appointment.

  • Download the forms, enter your info and print the form.

  • Arrive 15 minutes prior to the start of your appointment to complete the registration process.

  • For each follow-up visit, arrive 5-10 minutes early to change clothes. This allows the full appointment time to be used for treatment.

  • Please understand that regularly attending physical therapy treatments will be beneficial to your healing and well-being.

  • You will need to attend all scheduled physical therapy treatment sessions. If a situation beyond your control, such as illness arises, we ask you to notify us 24 hours in advance that you will not be able to attend your treatment. This consideration will allow for your scheduled appointment to be used for another patient. Missed appointments with less than 24 hour notice may be subject to a full price of service fee. On the third absence, you will be discharged until you have the opportunity to revisit your referring physician.

what you can expect

  • Your visit will be 40 to 60 minutes in length.

  • We will need copies of your insurance card for your records.

  • Bring your referral for physical therapy from your physician to your first appointment.

  • Bring loose fitting shorts if you are being treated for low back or leg problems.

  • The ExerScience Center will bill your insurance carrier. Insurance co-payments are to be paid at the time services are rendered. Payment arrangements can be made with the billing department. Please notify the front office staff if you have a possible claim and the reason why you are receiving treatment.

  • If your insurance company requires prior authorization for physical therapy treatment, please have your primary doctor request this before your first appointment.

To Cancel or reschudule an Appointment

If you need to cancel or reschedule a session, please contact The ExerScience Center at or 813.803.7070.

View the full list of Policies.

Acceptable Payment Options


Payments must be made in FULL before starting any training or classes. 

  • Private Pay

  • Accepted Credit Cards: VISA, Master Card, American Express, Discover

  • Accepted Debit Cards:  Visa & MasterCard

  • Healthcare Insurances (available soon)

  • PIP Claims

  • Health Savings Account (HSA) - Reimbursement 100%

  • *Out of Network - Reimbursement up to 70%

  • Discount Packages are available for Personal Training

  • Zen Power Pass - 10 fitness classes for $100 (saving of $50)

  • The ExerScience Center Gift Cards and Gift Certificates 

Billing and insurance


Payments must be made in FULL before starting any training or classes. 

The ExerScience Center will soon be accepting Medicare.  Please stay tuned. 


We are an out-of-network provider at the moment.  

We recommend patients contact their insurance company to find out what their out-of-network benefits include, so they know what to expect regarding reimbursement.


Here are some questions for them to ask:

  • Do I have out-of-network benefits?

  • Do my out-of-network benefits include physical therapy?

  • What is my out-of-network deductible?

  • Once my deductible is met, what percentage is reimbursed?

  • What is my out-of-pocket amount for my out-of-network benefits?

  • Are there any forms I need to complete online and fax in with my invoice?

  • Clarify the mailing address that the claim needs to be sent to.

  • Any other requirements needed for reimbursement?

Patients may need to complete forms from their insurance company and mail them in with the therapy session invoice and insurance cover letter.

The patient is responsible for payment at the time of service. See payment options.   The patient will be responsible for paying at the time of service and can submit for reimbursement to their insurance company.


24706 State Rd. 54

Lutz, Fl. 33559

(813) 803.7070

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©2014 by The Exerscience Center