Physical Therapy Evaluation Form

What is a physical therapy evaluation form?

A physical therapy evaluation form serves as a means to understand the patient’s existing and past physical conditions, the challenges they face, and their therapy goals. This document is used by the physical therapist to analyze the patient’s expectations from the therapy, their needs and preferences, and the challenges they face with respect to their physical abilities. Through this form, a therapist evaluates the best possible treatment that can be provided to the patient, and ensure that the patient’s health goals are being met. 

Why is a physical therapy evaluation form necessary?

A physical therapy evaluation form is important for both the patient and the therapist. While the therapist will be aware of the patient’s symptoms, history, and conditions; the patient will have a clear understanding of the objectives of the therapy, and how the therapist will approach the challenges. Without the physical therapy evaluation form, the therapist won’t be able to design the right therapy that aligns with the patient’s needs. Hence, it is crucial to have a form for physical therapy to ensure that the main objective of improving the patient’s physical health is being met. 

Who should fill out a physical therapy evaluation form?

A physical therapy evaluation form is generally filled out by a physical therapist, after a careful assessment of the patient’s functional abilities, physical challenges, and areas that need care. It may also require the assistance of the patient for filling up personal details. The form can also be filled out electronically. 

What details are included in a physical therapy evaluation form?

A physical therapy evaluation form typically includes the following:

• Patient’s personal details 
• Details of injury
• Medical history and therapy history 
• Details of allergies 
• Upper and lower extremities
• Safety awareness/responsiveness scale
• Medication history
• Treatment plan 
• Clinical goals 
• Goals from therapy  
• Details of physical therapist 

What are the legal requirements of a physical therapy evaluation form?

While the legal guidelines depend on the jurisdiction of the state, here are some common legal guidelines that therapists must comply with while designing the physical therapy evaluation form. These are:

• The form must be HIPAA-compliant 
• It must include the patient’s informed consent
• The patient’s information must be kept confidential 
• The form must clearly communicate with the patient