FREE Phone Consultation

(651) 275-4706

Please arrive for your first appointment 20 minutes early for check in and insurance verification. Download, print, and complete the applicable forms to bring to your first appointment. Descriptions of the forms are also provided below.

New Patient Forms

Medical History Form

This form must be completed by all new and returning patients. It gives us important information that your therapist needs to develop a treatment plan for your therapy.

Medication List Form

Provides us with information on medication name, dosage, reason for taking, frequency, and how it is taken. This is important for your therapist to know in developing your treatment plan.


This form describes how the health insurance information that you provide may be used and disclosed. This is required by the Health Insurance Portability and Accountability Act of 1996.

Consent For Minors

OSI requires that a parent or legal guardian accompany any minor children to their medical appointment. If a parent is unable to accompany a minor child to an appointment, the parent or legal guardian must sign this form.

Medicare Cap Information Letter

This is informational only, and does not require a signature. It describes the annual financial limit (cap) on therapy services that Medicare has in place.

Also print the following forms if they apply to you:

Click here to download the OSI Referral Form. This form is available for physicians to download if they run out of referral pads. If you are a physician and need more referral pads, please call 651-275-4706

OSI Physical Therapy orthopedic center and orthopedic specialists are committed to meet your physical rehabilitation and exercise rehabilitation needs.